Intracameral air viable alternative for hydrops, physician says

SANTIAGO, Chile — Injecting intracameral air as a treatment for hydrops secondary to keratoconus is a safe and economical alternative to conventional treatments, according to a speaker here at the Pan-American Congress of Ophthalmology.

Victor J. Rojas Hernández, MD, said hydrops is manifested by severe corneal edema, caused by a tear in Descemet’s membrane. It occurs in 4% to 6% of patients with keratoconus worldwide, he said.

Dr. Hernández and colleagues studied 84 patients with keratoconus to see who would develop hydrops. A total of 11 eyes of 10 patients presented with corneal hydrops secondary to keratoconus. These were divided into two groups; Group A received an injection of intracameral air (roughly 0.2 mL of air), and Group B was treated conventionally with hyperosmotics, beta-blockers and fluoromethalone.

In Group A, pain, tears and other symptoms nearly vanished, visual recuperation was improved, and recuperation time was reduced by nearly two-thirds, Dr. Hernández said.

The injection of intracameral air is “safe and economical” for corneal hydrops, he concluded.

“The rapid resolution of hydrops helps us to conduct transplants within a shorter time period. It helps us to perhaps think about other types of surgery, such as deep lamellar keratoplasty, which cannot be done when there is hydrops. Obviously, this could also help to reduce the percentage of (corneal) grafts that are rejected,” he said.