A modified technique of compression sutures combined with intracameral sulfur hexafluoride (SF6) for acute corneal hydrops

Purpose: This study aimed to present cases of acute corneal hydrops managed using a modified compression suture technique and intracameral gas tamponade. Methods: Eight cases presented to the emergency room with acute drop in vision, corneal opacity, and Descemet’s membrane defects. The primary diag...

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Main Authors: Omar Kirat, Nada K. Naaman, Adhwa Alsadoon, Halah Bin Helayel, Rafah Fairaq
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:AJO International
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Online Access:http://www.sciencedirect.com/science/article/pii/S2950253525000437
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author Omar Kirat
Nada K. Naaman
Adhwa Alsadoon
Halah Bin Helayel
Rafah Fairaq
author_facet Omar Kirat
Nada K. Naaman
Adhwa Alsadoon
Halah Bin Helayel
Rafah Fairaq
author_sort Omar Kirat
collection DOAJ
description Purpose: This study aimed to present cases of acute corneal hydrops managed using a modified compression suture technique and intracameral gas tamponade. Methods: Eight cases presented to the emergency room with acute drop in vision, corneal opacity, and Descemet’s membrane defects. The primary diagnoses included keratoconus in six cases, pellucid marginal degeneration (PMD) in one, and post-refractive ectasia in one. They were managed using a modified compression suture technique and intracameral air/gas tamponade. The procedure included creating a small surgical inferior peripheral iridectomy, followed by intracameral injection of sulfur hexafluoride (SF6) 20 % , and suturing the Descemet’s membrane defect with 10–0 Prolene using a straight needle in a continuous crisscross, horizontal cruciate mattress full-thickness technique. Results: A total of eight eyes from eight patients were included. The series consisted of four males (50 %) and four females (50 %), with a median age of 27 years (range: 12–58 years). The median duration of hydrops symptoms prior to presentation was 24 days (range: 16–60 days). Uncorrected visual acuity at presentation ranged from 20/200 to hand motion. The median time for corneal edema resolution postoperatively was 2 weeks (range: 1–3 weeks). Sutures were removed at two months with no documented recurrences. Final uncorrected visual acuity ranged from 20/50 to 20/200, with a median of 20/80, excluding one patient with a difficult-to-assess visual acuity. Conclusions: The modified compression suturing technique appears to be an effective alternative with a double mattress effect for expediting corneal edema resolution and Descemet’s membrane defect closure. Advantages include facilitating contact lens fitting and reducing the risk of corneal neovascularization. This technique may be particularly beneficial for pediatric and high-risk patients, including those who are mentally challenged, when postponing keratoplasty is necessary.
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spelling doaj-art-db13fcdefe5e4ceb8637cd803a337ff52025-08-20T03:19:57ZengElsevierAJO International2950-25352025-07-012210014010.1016/j.ajoint.2025.100140A modified technique of compression sutures combined with intracameral sulfur hexafluoride (SF6) for acute corneal hydropsOmar Kirat0Nada K. Naaman1Adhwa Alsadoon2Halah Bin Helayel3Rafah Fairaq4Anterior Segment Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi ArabiaCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia; Department of Ophthalmology, Ministry of National Guard - Health Affairs, Jeddah, Saudi ArabiaFellowship and Residency Training Program, King Khaled Eye Specialist Hospital, Riyadh, Saudi ArabiaAnterior Segment Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi ArabiaAnterior Segment Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; Corresponding author at: Anterior Segment Division, King Khaled Eye Specialist Hospital, Uruba Road, Riyadh 11462, Saudi Arabia.Purpose: This study aimed to present cases of acute corneal hydrops managed using a modified compression suture technique and intracameral gas tamponade. Methods: Eight cases presented to the emergency room with acute drop in vision, corneal opacity, and Descemet’s membrane defects. The primary diagnoses included keratoconus in six cases, pellucid marginal degeneration (PMD) in one, and post-refractive ectasia in one. They were managed using a modified compression suture technique and intracameral air/gas tamponade. The procedure included creating a small surgical inferior peripheral iridectomy, followed by intracameral injection of sulfur hexafluoride (SF6) 20 % , and suturing the Descemet’s membrane defect with 10–0 Prolene using a straight needle in a continuous crisscross, horizontal cruciate mattress full-thickness technique. Results: A total of eight eyes from eight patients were included. The series consisted of four males (50 %) and four females (50 %), with a median age of 27 years (range: 12–58 years). The median duration of hydrops symptoms prior to presentation was 24 days (range: 16–60 days). Uncorrected visual acuity at presentation ranged from 20/200 to hand motion. The median time for corneal edema resolution postoperatively was 2 weeks (range: 1–3 weeks). Sutures were removed at two months with no documented recurrences. Final uncorrected visual acuity ranged from 20/50 to 20/200, with a median of 20/80, excluding one patient with a difficult-to-assess visual acuity. Conclusions: The modified compression suturing technique appears to be an effective alternative with a double mattress effect for expediting corneal edema resolution and Descemet’s membrane defect closure. Advantages include facilitating contact lens fitting and reducing the risk of corneal neovascularization. This technique may be particularly beneficial for pediatric and high-risk patients, including those who are mentally challenged, when postponing keratoplasty is necessary.http://www.sciencedirect.com/science/article/pii/S2950253525000437Corneal hydropsKeratoconusGas tamponadeCorneal ectasia
spellingShingle Omar Kirat
Nada K. Naaman
Adhwa Alsadoon
Halah Bin Helayel
Rafah Fairaq
A modified technique of compression sutures combined with intracameral sulfur hexafluoride (SF6) for acute corneal hydrops
AJO International
Corneal hydrops
Keratoconus
Gas tamponade
Corneal ectasia
title A modified technique of compression sutures combined with intracameral sulfur hexafluoride (SF6) for acute corneal hydrops
title_full A modified technique of compression sutures combined with intracameral sulfur hexafluoride (SF6) for acute corneal hydrops
title_fullStr A modified technique of compression sutures combined with intracameral sulfur hexafluoride (SF6) for acute corneal hydrops
title_full_unstemmed A modified technique of compression sutures combined with intracameral sulfur hexafluoride (SF6) for acute corneal hydrops
title_short A modified technique of compression sutures combined with intracameral sulfur hexafluoride (SF6) for acute corneal hydrops
title_sort modified technique of compression sutures combined with intracameral sulfur hexafluoride sf6 for acute corneal hydrops
topic Corneal hydrops
Keratoconus
Gas tamponade
Corneal ectasia
url http://www.sciencedirect.com/science/article/pii/S2950253525000437
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