title: Spontaneous bilateral corneal perforation of acute hydrops in keratoconus.
abstract: OBJECTIVE
  To report an uncommon case of bilateral spontaneous corneal perforation in keratoconus.
  
  
  METHODS
  Interventional case report.
  
  
  METHODS
  A 63-year-old man with a long history of keratoconus (more than 30 years) experienced acute hydrops and corneal perforation in his right eye. One year later, he had the same clinical features in his left eye.
  
  
  RESULTS
  After initial treatment with cyanoacrylate glue and bandage soft contact lenses, therapeutic penetrating keratoplasty was performed with good visual outcome in both eyes.
  
  
  CONCLUSIONS
  Special attention should be paid to the possibility of spontaneous corneal perforation during acute hydrops in patients with severe corneal thinning, biomicroscopic findings of advanced disease, and high keratometry readings.
authors.affiliation: Department of Ophthalmology, Corneal and External Disease Service, Sorocaba Eye Hospital and Faculty of Medical Sciences, Santa Casa of São Paulo, Rua Martinico Prado 26, Conj. 181/182, CEP 01224-010 São Paulo, Brazil. pauloecdantas@uol.com.br
authors.forename: Paulo Elias C
authors.initials: PE
authors.lastname: Dantas
authors.forename: M Cristina
authors.initials: MC
authors.lastname: Nishiwaki-Dantas
mesh_terms: D000208:Acute Disease; D003263:Contact Lenses, Hydrophilic; D003315:Cornea / Q000473:pathology* / Q000601:surgery; D015715:Corneal Edema / Q000209:etiology* / Q000601:surgery; D003487:Cyanoacrylates / Q000627:therapeutic use; D006801:Humans; D007640:Keratoconus / Q000150:complications* / Q000601:surgery; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D012422:Rupture, Spontaneous; D014014:Tissue Adhesives / Q000627:therapeutic use; D014945:Wound Healing / Q000187:drug effects
chemical_list: D003487:Cyanoacrylates; D014014:Tissue Adhesives