Spontaneous Corneal Hydrops and Perforation in Keratoconus and Pellucid Marginal Degeneration

Department of Ophthalmology, Francis I. Proctor Foundation, University of California-San Francisco, San Francisco, CA, USA.
Cornea (Impact Factor: 2.04). 04/2003; 22(2):169-74. DOI: 10.1097/00003226-200303000-00019
Source: PubMed


To report two cases of pellucid marginal degeneration and one case of keratoconus associated with spontaneous corneal hydrops leading either to perforation or imminent perforation, requiring urgent keratoplasty.
Retrospective interventional case series of three patients with noninflammatory peripheral corneal degenerations. A retrospective review was done of the clinical courses, surgical interventions, and pathologic specimens, development of spontaneous hydrops, perforation, need for surgical intervention, and final visual outcome.
Two patients with pellucid marginal degeneration and one with keratoconus developed spontaneous hydrops followed by aqueous leakage through markedly thinned anterior stroma. In one case, the leak site was successfully sealed after three separate applications of tissue adhesive, although the remaining two cases required penetrating keratoplasty.
These cases document the very unusual occurrence of corneal hydrops leading to spontaneous corneal perforation in patients with keratoconus and pellucid marginal degeneration.

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    • "Classically, the onset of KCN is during puberty and the condition is progressive until the third or fourth decades of life.1 KCN may be associated with corneal hydrops due to rupture of the endothelium and Descemet membrane, permitting aqueous to enter the stroma. Corneal hydrops occurs in approximately 3% of eyes with KCN.2 Few cases of KCN attributed to eye rubbing have been reported.3-6 Herein, we present a seven-year-old girl with KCN attributed to eye rubbing associated with vernal keratoconjunctivitis (VKC) with severe corneal hydrops leading to marked visual impairment and corneal scarring. "
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    ABSTRACT: Purpose To report a young child with bilateral keratoconus in the context of vernal keratoconjunctivitis (VKC) who developed bilateral corneal hydrops associated with eye rubbing, and to discuss the pathogenesis and review the pertinent literature. Case Report A seven-year-old girl with VKC and asymmetric keratoconus developed corneal hydrops due to habitual eye rubbing. Corneal edema subsided within 16 weeks in her right eye and 9 weeks in the left eye with subsequent corneal scarring. Conclusion Continuous mechanical trauma, such as eye rubbing, plays a significant role in the pathogenesis of keratoconus and subsequent hydrops even in childhood.
    Journal of Ophthalmic & Vision Research 01/2014; 9(1):101-5.
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    • "It may be possible that retention of abnormal DM and posterior stroma encourages the progression of degenerative changes leading to recurrence of keratoconus after DALK. Although, recurrent keratoconus has also been reported following PK, this seems to be a rare complication which occurs no earlier than 2 decades after surgery.4-8 Herein, we present the second case of recurrent keratoconus relatively short after DALK. "
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    ABSTRACT: To report the recurrence of keratoconus 49 months after deep anterior lamellar keratoplasty (DALK). A 21-year-old man with history of bilateral keratoconus who had undergone DALK in his right eye, presented with gradual visual loss 49 months after corneal transplantation. Slit lamp biomicroscopy revealed graft ectasia together with Vogt's striae in the posterior stroma and corneal topography demonstrated inferior steepening. With a diagnosis of recurrent keratoconus in the graft, the patient underwent penetrating keratoplasty (PK) and histopathological examination confirmed the diagnosis of keratoconus in the graft. Similar to PK, keratoconus can recur in the transplanted cornea after DALK. However, the time interval from transplantation to recurrence seems to be much shorter in DALK grafts.
    10/2012; 7(4):328-31.

  • Cornea 11/2003; 22(7):705-6. DOI:10.1097/00003226-200310000-00016 · 2.04 Impact Factor
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