Partial Thickness Compression Sutures Without Intracameral Air For Acute Corneal Hydrops In Corneal Ectasia: A Safe And Effective Alternative

To evaluate the efficacy and safety of partial thickness compression sutures without intracameral air tamponade in the management of acute corneal hydrops in corneal ectasia.

Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom.

A retrospective case series was performed of patients presenting to a tertiary corneal service with acute hydrops secondary to keratoconus or pellucid marginal degeneration between 2024–2025. All cases were managed with partial-thickness 10-0 nylon corneal sutures without intracameral gas. Eyes receiving air or full-thickness sutures were excluded. Data included demographics, time to surgery, best-corrected visual acuity (BCVA), central corneal thickness (CCT via MS-39 AS-OCT), complications, and time to oedema resolution.

Seven eyes from six patients (median age 29 years, range 17–64) were included. All were treated with partial-thickness sutures alone. Five of seven eyes had BCVA ≤3/60 at presentation; postoperatively, 6/7 showed improvement, with three recovering to 6/18 or better. Mean CCT reduced from 1000 µm pre-op to 600 µm at 1 week, and 520 µm at 1 month. Median time to corneal oedema resolution was one month. No intraoperative or postoperative complications were observed.

Partial-thickness compression sutures without intracameral gas offer a safe and effective alternative in the surgical management of acute hydrops. This approach avoids risks associated with anterior chamber entry, including pupillary block and cataract. Further comparative studies are needed to evaluate long-term outcomes and refine indications.