Acute Corneal Hydrops Complicated by Microbial Keratitis: Case Series Reveals Poor Immediate and Long-Term Prognosis.

OBJECTIVE

Acute corneal hydrops is a rare complication of keratoconus and may be a risk factor for further complications such as microbial keratitis.

METHODS

Retrospective, case series.

RESULTS

Six eyes developed microbial keratitis during acute corneal hydrops. Risk factors for the development of microbial keratitis included epithelial defect, contact lens wear, trichiasis, and use of topical steroids. Two eyes developed corneal perforation and 1 eye was treated for possible endophthalmitis. All eyes developed marked scarring and neovascularization with final visual acuity of 20/200 or less. Three eyes received penetrating keratoplasty, and each experienced endothelial rejection with 1 eye developing graft failure.

CONCLUSIONS

Microbial keratitis is a rare complication that may develop during acute corneal hydrops. The infection may rapidly appear and spread throughout the cornea and can lead to severe corneal scarring, neovascularization, and loss of vision and may prejudice subsequent keratoplasty. Prophylactic topical antibiotics should always be considered when treating acute corneal hydrops.