Purpose: This study is aimed to evaluate the role of 14% nonexpansile concentration of perfluoropropane (C(3)F(8)) gas in the management of acute hydrops in corneal ectasias.
Design: Retrospective, nonrandomized, comparative, interventional case series.
Participants and controls: The study group consisted of 62 eyes of 57 patients and the control group included 90 eyes of 82 patients with acute corneal hydrops who presented within 30 days of onset of symptoms.
Intervention: Patients in the control group underwent a single intracameral injection of 0.1 mL of nonexpansile concentration (14%) of C(3)F(8) gas. Patients in the control group were treated conservatively. Patients in both groups were followed regularly for 12.6±7.7 and 13.4±8.3 months in the study and control groups, respectively, and assessed clinically for complete disappearance of epithelial and stromal edema on slit-lamp biomicroscopy.
Main outcome measures: The primary outcome measure was mean time to resolution of corneal edema, which was calculated both from the date of onset of hydrops and the date of initiation of therapy to the date of resolution in days.
Results: The overall time to resolution both from the date of onset of symptoms (90.5±55.8 vs 125±68.9 days; P = 0.0005) and from the date of initiation of therapy (78.7±53.2 vs 117.9±68.2 days; P = 0.0001) was significantly lower in the study group compared with the control group. However, on subgroup analysis a significant difference in the resolution time was found only in eyes with keratoconus (P<0.0001). No difference in the resolution time was seen in eyes with pellucid marginal corneal degeneration (PMCD) or keratoglobus. The main complication of this procedure was reversible pupillary block (16%; P<0.0001). There was no difference in the final visual acuity or endothelial cell counts between the 2 groups.
Conclusions: Intracameral C(3)F(8) gas in a nonexpansile concentration is a useful modality for faster resolution of corneal edema in patients with acute corneal hydrops and keratoconus, and its role in the treatment of PMCD and keratoglobus needs further evaluation.
Copyright © 2011 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.