Acute Hydrops in the Donor Cornea Graft in Non-Keratoconus Patients
A 91-year-old Caucasian male with a history of PKP in the right eye was referred to the clinic for descemetocele evaluation. He had a corneal transplant of the right eye originally for pseudophakic bullous keratopathy. The patient reported frequent eye rubbing. On examination, he had light perception with projection in the right eye and 20/25 best-corrected vision in the left eye. The manifest refraction in the left eye was −1.50 + 1.50 × 141. Intraocular pressure was not measurable in the right eye and was 14 mm Hg in the left eye. A very large pedunculated cyst was seen within the corneal graft in the right eye []. There was no evidence of keratoconus in the fellow eye. OCT of the anterior segment revealed a deep stromal cystic cavity consistent with the hydrops. UBM of the anterior segment showed the presence of an anterior chamber intraocular lens and a large cystic cavity with a suspected break in the superior region of Descemet's membrane. The patient subsequently received a PKP of the right eye. The anterior chamber intraocular lens was an open-loop Kelman-style and was left in place. The corneal graft was oversized by 0.5 mm. Pathology examination revealed marked central corneal edema consistent with the hydrops. Descemet's membrane was absent except for fragments on both sides of the button.