The Results of Corneal Hydrops Treatment in Patients with Down Syndrome

Abstract

The article describes the clinical cases of acute keratoconus in three patients with Down syndrome who underwent penetrating keratoplasty. Acute keratoconus were diagnosed in patients by examination of medical history, biomicroscopy, corneal topography, optical coherence tomography. Acute keratoconus occurs suddenly due to the rupture of Descemet’s membrane in the zone of its stretching, when chamber moisture seeps into the thickness of the stroma, causing its swelling and perforation. If untreated, the process continues for 3–5 months. Most researchers recommend keratoplasty during the cold period of the disease. However, with the threat of perforation require urgent surgical intervention. There are two effective methods of surgical treatment: epikeratophakia and penetrating keratoplasty. Patients underwent penetrating keratoplasty. The preference for this method was given in connection with the following factors: young age patients (under 40 years), relatively healthy transparent peripheral zone of the cornea, which was observed in our patients, genetically determined diseases — Down syndrome, the threat of corneal perforation in the centre, a penchant for rubbing his eye, low vision other eye and the desire to obtain speedy optical effect along with the treatment. All patients after penetrating keratoplasty had improvement of visual acuity with observation periods up to 1 year. Due to the relatively high incidence of keratoconus in patients with Down syndrome should focus the attention of ophthalmologists. Thus, difficulties in the diagnosis of ophthalmic pathology in patients with concomitant Down syndrome can cause errors in verification of diagnosis and hence wrong treatment selection. In case of hydrops of the cornea penetrating keratoplasty is the choice treatment and contributes to the preservation of the eye and visual functions.