Journal of investigative surgery : the official journal of the Academy of Surgical Research · 2026
Therapeutic Outcomes of Three Surgical Approaches for Acute Corneal Hydrops.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Bai Jie, Li Shaowei, Liu Chang, Li Ling, Zhao Lin, Dou Zexia
Аннотация
PURPOSE: To compare therapeutic outcomes of three surgical approaches for acute corneal hydrops (ACH): compression sutures combined with intracameral air injection (CSAI), CSAI followed by deep anterior lamellar keratoplasty (DALK), and penetrating keratoplasty (PKP).
METHODS: This study enrolled 26 patients (26 eyes) into three groups: CSAI-only (7 eyes), CSAI+DALK (14 eyes), and PKP (5 eyes). Demographics; best-corrected visual acuity (BCVA), corneal edema area, central corneal thickness (CCT), corneal curvature during the acute phase; resolution time after CSAI; BCVA, corneal curvature, CCT, astigmatism at final follow-up; and complications were collected.
RESULTS: Mean corneal edema resolution time after CSAI was approximately 2 weeks. Postoperative BCVA (logMAR) improved in all groups (p < 0.05): CSAI-only (0.60 ± 0.15), CSAI+DALK (0.34 ± 0.16), PKP (0.15 ± 0.09). Among 17 eyes planned for DALK, Descemet's membrane perforation occurred in 5 eyes. One PKP case had graft rejection, no long-term complications in the other two groups.
CONCLUSIONS: CSAI shortens ACH duration but offers limited visual improvement, serving as a phased treatment. DALK after CSAI resolution significantly improves BCVA and reduces graft rejection risk, making CSAI+DALK a preferred balanced approach. PKP provides the greatest BCVA but carries higher rejection risk, reserved for non-suitable cases of other options.
METHODS: This study enrolled 26 patients (26 eyes) into three groups: CSAI-only (7 eyes), CSAI+DALK (14 eyes), and PKP (5 eyes). Demographics; best-corrected visual acuity (BCVA), corneal edema area, central corneal thickness (CCT), corneal curvature during the acute phase; resolution time after CSAI; BCVA, corneal curvature, CCT, astigmatism at final follow-up; and complications were collected.
RESULTS: Mean corneal edema resolution time after CSAI was approximately 2 weeks. Postoperative BCVA (logMAR) improved in all groups (p < 0.05): CSAI-only (0.60 ± 0.15), CSAI+DALK (0.34 ± 0.16), PKP (0.15 ± 0.09). Among 17 eyes planned for DALK, Descemet's membrane perforation occurred in 5 eyes. One PKP case had graft rejection, no long-term complications in the other two groups.
CONCLUSIONS: CSAI shortens ACH duration but offers limited visual improvement, serving as a phased treatment. DALK after CSAI resolution significantly improves BCVA and reduces graft rejection risk, making CSAI+DALK a preferred balanced approach. PKP provides the greatest BCVA but carries higher rejection risk, reserved for non-suitable cases of other options.