ESCRS - PO251 - Oct Changes In The Corneal Architecture Following Corneal Hydrops

Oct Changes In The Corneal Architecture Following Corneal Hydrops

Published 2024 - 42nd Congress of the ESCRS

Reference: PO251 | Type: Poster | DOI: 10.82333/x6m6-2274

Authors: Aguenaou Sarah* 1 , el hassan abdallah 2

1OPHT B,HSR,RABAT,Morocco, 2b,her,rabat ,Morocco

Purpose

  • The purpose of our study was to investigate the morphological characteristics of corneal hydrops by analyzing OCT images to understand advanced keratoconus and its evolution over the years, and to establish the best therapeutic and surgical indication for these patients from disadvantaged backgrounds seen at advanced stages of the disease, in order to offer a brighter future by improving their visualacuity using the technique of transfixing keratoplasty or DALK

Setting

  • We report the observations of four patients with keratoconus at different stages of evolution who had OCT examinations , aged between 23  and 29,  examined for the first time in our structure, not known keratoconics before
  • 3 patients benefited from transfixing keratoplasty

Methods

  1. Four patients with keratoconus were included . All patients were followed up at the rabat ophthalmology department B between January and February 2023.
  2.  All patients underwent a complete bilateral ophthalmological examination, including visual acuity measurement, corneal topography confirming the existence of keratoconus, slit lamp examination, intraocular pressure measurement, fundus examination and OCT corneal photography.
  • case 1:  26 years old patient examinated  3 weeks post hydrops
  • case 2: 23 years old with down syndrom patient presented a keratoconus complicated by untreated hydrops 6 months ago 
  • Case3 :A 29year-old woman with  hydrops at 1 month of evolution
  • case 4 : 27year-old woman with advanced hydrops18months after acute keratoconus

 

Results

 

  • 1:thinning of the epithelial and stromal layers in the corneal cone, hyperreflectivity in Bowman's layer and epithelial thickening with the appearance of pan-stromal scarring in the coneTopography confirms stage 4 keratoconus
  • 2:thinned scarring cornea with a dense subepithelialfibrosis laceration testifying the longstanding nature of this complication, with panstromal scarring and the residual appearance of Descemet'smembrane rupture
  • 3:closure of the endothelial-descemetic space and some corneal edema cysts as well as thickening of the subepithelial folds and densification of the fibrosis network which became more diffuse and hyperreflective
  •  4:significantcornealthinningwithpan-stromalscarandresidualappearanceofruptureof Descemet'smembrane

 

 

 

Conclusions

  • OCT has made it possible to improve the diagnosisof keratoconus, particularly in advanced forms. It provides important information regarding the anatomical changes of the keratoconic cornea and allows precise measurements of the different corneal layers to be taken and then improving therapeutic management and patient monitoring