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Severity Assessment of Acute Hydrops Due to Recurrent Keratoconus after Penetrating Keratoplasty Using Anterior Segment Optical Coherence Tomography
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- Asahi Fujita
- Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan
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- Junko Yoshida
- Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan
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- Tetsuya Toyono
- Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan
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- Tomohiko Usui
- Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan
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- Takashi Miyai
- Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan
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Description
Purpose: To compare the clinical characteristics of acute hydrops between eyes with recurrent keratoconus and eyes with treatment-naive keratoconus.Methods: Six eyes with acute hydrops caused by recurrent keratoconus (recurrent group) and 29 eyes with acute hydrops due to treatment-naive keratoconus (naive group) were included. We collected data from anterior-segment optical coherence tomography (AS-OCT), corneal topography and medical records. With AS-OCT, we investigated the location of Descemet's membrane break, the length and frequency of Descemet's membrane detachment, and the speed of corneal thinning before acute hydrops.Results: Descemet's membrane breaks were detectable in 6 cases in the recurrent group (100%) and 7 cases in the naive group (70%). Distance from the break to the central line was 2-3 mm in the recurrent group, and less than 1 mm in the naive group (p < .001). Detachment length was significantly greater in the recurrent group than in the naive group (p = .003). Steep corneal power values tended to increase before acute hydrops in the recurrent group, but the difference between groups was not significant (observation period; 6.03 ± 2.67, 7.36 ± 5.53 years, respectively). Penetrating keratoplasty was required in 5 cases (83%) in the recurrent group, and 8 cases (28%) in the naive group (p = .02).Conclusions: Acute hydrops due to recurrent keratoconus occurred around graft-host junctions and was more severe than that in eyes with treatment-naive keratoconus. Severity assessment of Descemet's membrane detachment using AS-OCT provided clues not only for diagnosis, but also for predicting prognosis.
Journal
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- Current Eye Research
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Current Eye Research 44 (11), 1189-1194, 2019-06-13
Informa UK Limited
