Abordagem cirúrgica em casos refratários de hidropsia corneana - série de casos

Abstract

Acute corneal hydrops (HCA) is a rare complication of keratoconus (2.5 to 3%), which leads to the rupture of Descemet's membrane and passage of aqueous humor to the stroma and corneal epithelium. The surgical treatment of HCA isn't well established in the literature and remains an underused alternative. Patient A, female, 38 years old, visual acuity (AV) of fingers count (DC) at 50cm in the left eye (LE). There was worsening during clinical treatment: AV of hand movement (MM) (16th day) and no longer walked without help (33rd). Optical Coherence Tomography (OCT) with a corneal thickness of 1.69 mm (33rd day). Three days after surgical treatment, she had 0.68 mm at OCT, discreet opacity, adhered MD and final AV of 20/400. Patient B, female, 20 years old, previous keratoconus and acute AV reduction in the right eye: DC at 50 cm. Without improvement in clinical treatment, surgical treatment was performed with intervention on the 14th day, without improvement, OCT with a thickness of 1.67mm. Four stitches of compressive sutures were added in the cornea and after 5 days OCT with 0.60 mm, adhered MD and final corrected AV of 20/150. The objective of this work is to present, through two case reports, the surgical treatment of HCA as an effective, alternative and early results method. Clinical treatment is usually effective, but in case of failure, surgical treatment can be satisfactory. The addition of corneal compression sutures further accelerates recovery and prevents repeated interventions.