title: Efficacy and safety of pre-Descemet's membrane sutures for the management of acute corneal hydrops in keratoconus.
abstract: OBJECTIVE
  The aim of this study was to assess the efficacy and safety of pre-Descemet's membrane (DM) sutures associated with intracameral air injection for management of acute corneal hydrops associated with keratoconus.
  
  
  METHODS
  We carried out a retrospective interventional study of seven consecutive cases. Three to seven pre-DM sutures with 10-0 nylon were applied perpendicularly to the tear as close as possible to DM, under general anaesthesia. An air bubble was injected into the anterior chamber at the end of each procedure.
  
  
  RESULTS
  Corneal oedema began to decrease from day 1 after surgery in all our patients. Best-corrected visual acuity progressed from 2.13 to 1.65 logMar (p=0.031) 1 month after surgery, and from 2.13 to 0.84 logMar (p=0.016) 2 months after surgery. The mean corneal thickness measured by anterior segment optical coherence tomography decreased from 1472 µm (range 689-2770 µm) on day 0 to 909 µm (range 484-1640 µm) on day 1 (p=0.016), 716 µm (range 484-1380 µm) on day 15 (p=0.016) and 528 µm (range 404-618 µm) 1 month after surgery.
  
  
  CONCLUSIONS
  Our results suggest that intrastromal pre-DM sutures and intracameral air injection could promptly restore imperviousness of posterior stroma. This technique seems to be a safe and useful procedure to shorten acute corneal hydrops.
authors.affiliation: Department of Ophthalmology, Charles Nicolle University Hospital, Rouen, France.
authors.forename: H
authors.initials: H
authors.lastname: Yahia Chérif
authors.affiliation: Department of Ophthalmology, Charles Nicolle University Hospital, Rouen, France.
authors.forename: J
authors.initials: J
authors.lastname: Gueudry
authors.affiliation: Department of Ophthalmology, Charles Nicolle University Hospital, Rouen, France.
authors.forename: M
authors.initials: M
authors.lastname: Afriat
authors.affiliation: Department of Ophthalmology, Charles Nicolle University Hospital, Rouen, France.
authors.forename: A
authors.initials: A
authors.lastname: Delcampe
authors.affiliation: Department of Ophthalmology, Charles Nicolle University Hospital, Rouen, France.
authors.forename: P
authors.initials: P
authors.lastname: Attal
authors.affiliation: Department of Ophthalmology, Charles Nicolle University Hospital, Rouen, France.
authors.forename: H
authors.initials: H
authors.lastname: Gross
authors.affiliation: Department of Ophthalmology, Charles Nicolle University Hospital, Rouen, France.
authors.forename: M
authors.initials: M
authors.lastname: Muraine
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000388:Air; D003131:Combined Modality Therapy; D015715:Corneal Edema / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D003886:Descemet Membrane / Q000293:injuries / Q000601:surgery*; D058450:Endotamponade; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000150:complications* / Q000175:diagnosis; D008297:Male; D009757:Nylons; D012189:Retrospective Studies; D012421:Rupture / Q000517:prevention & control; D013536:Suture Techniques; D013537:Sutures; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
chemical_list: D009757:Nylons
keywords: Cornea; Descemet's Membrane; Dua's layer; Keratoconus