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A 53 year old man with keratoconus and a steroid related intraocular pressure response developed acute hydrops and underwent deep anterior lamellar keratoplasty after poor spontaneous recovery of vision. Intraocular pressure rose to 40 mm Hg on postoperative administration of topical prednisolone 0.5%, resulting in a well localised area of stromal oedema. Resolution of the oedema followed reduction of intraocular pressure, but recurrence ensued if the pressure rose above 30 mm Hg. Following acute hydrops, the regenerative process involves endothelial proliferation across the break in Descemet’s membrane. This localised functional deficit is demonstrated after only a moderate intraocular pressure rise.
A 53 year old man was referred with acute hydrops in the left eye. He had a history of asthma, severe atopic keratoconjunctivitis, keratoconus, …