Official ESCRS | European Society of Cataract & Refractive Surgeons


Are Descemet's membrane ruptures the root cause of corneal hydrops in keratoconic eyes?

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Session Details

Session Title: Keratoconus

Session Date/Time: Monday 16/09/2019 | 14:00-16:00

Paper Time: 14:12

Venue: Free Paper Forum: Podium 2

First Author: : J.Parker USA

Co Author(s): :    K. van Dijk   R. Birbal   S. Oellerich   I. Dapena   G. Melles                 

Abstract Details


To challenge the current consensus on the mechanism for corneal hydrops in eyes with keratoconus (KC).


A retrospective, interventional case series conducted at the Netherlands Institute for Innovative Ocular Surgery and Parker Cornea.


Sixteen eyes of 10 patients with comorbid KC and Fuchs endothelial corneal dystrophy (FECD) underwent uncomplicated Descemet membrane endothelial keratoplasty (DMEK), and 5 eyes of 5 patients with KC alone underwent Bowman layer (BL) transplantation, complicated by inadvertent perforation of the posterior corneal stroma and Descemet membrane (DM). The presence or absence of hydrops was assessed by intra- and postoperative optical coherence tomography and by slit-lamp biomicroscopy.


None of the 16 DMEK eyes manifested a hydrops at any time during or after surgery. By contrast, all 5 eyes undergoing BL transplantation complicated by posterior corneal perforation demonstrated a corneal hydrops, evident both intra- and postoperatively.


In eyes with KC, even the complete removal of DM did not produce a hydrops, whereas a combined defect in DM and the posterior corneal stroma seemed to consistently elicit a typical corneal hydrops.

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