Clinical profile and etiological spectrum of patients presenting with corneal hydrops over a 12-year period.

PURPOSE: To describe the demographics, clinical characteristics, and management of corneal hydrops in patients presenting to a multi-tier ophthalmology hospital network in India.

DESIGN

Cross-sectional hospital-based study.

METHODS

Of the total of 3,140,941 new patients presenting between October 2010 and March 2022, patients with a clinical diagnosis of corneal hydrops in at least one eye were included in the study. All the data was collected using an electronic medical record system.

RESULTS

1291 eyes of 1110 patients were diagnosed with corneal hydrops and included in the study and 961 patients (83.69%) had a unilateral affliction. Corneal hydrops was noted to be significantly more common in males (62.43%) and adults (62.7%). The most common age group at presentation was during the second decade of life with 472 (42.52%) patients. They were more commonly from the higher socio-economic status (77.3%) and from the urban geography (44.23%). In the 1291 eyes, 567 (43.92%) eyes had a visual impairment of blindness (> 20/400-20/1200) followed by moderate visual impairment (> 20/70-20/200) in 166 (12.86%) eyes. Overall, the most common etiology was keratoconus in 1,082 (83.81%) eyes followed by primary congenital glaucoma (PCG) in 91 (7.05%) eyes. Surgical intervention to hasten the recovery of hydrops was performed in 7.82% of eyes with ectasia and as a definite management in 7.05% eyes with PCG. Visual rehabilitation was with contact lenses in 29.1% eyes and keratoplasty in 13.94% eyes.

CONCLUSION

Corneal hydrops is predominantly unilateral and is more common in males. Keratoconus was the commonest etiological condition; however, the risk of hydrops was highest in keratoglobus, followed by PMD. Most affected age was the second decade of life and visual impairment was severe in majority (60%). A surgical intervention was performed in a third of the cases.