Article Text

Download PDFPDF
Compression sutures combined with intracameral air injection versus thermokeratoplasty for acute corneal hydrops: a prospective-randomised trial
  1. Zelin Zhao1,2,
  2. Siteng Wu1,2,
  3. Weina Ren3,
  4. Qinxiang Zheng1,2,
  5. Cong Ye1,2,
  6. Andy D. Kim4,
  7. Vishal Jhanji5,
  8. Michael T. M. Wang4,
  9. Wei Chen1,2
  1. 1 Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
  2. 2 National Clinical Research Center for Ocular Diseases, Wenzhou, China
  3. 3 Yinzhou People’s Hospital, Ningbo, China
  4. 4 Department of Ophthalmology, The University of Auckland New Zealand National Eye Centre, Auckland, New Zealand
  5. 5 Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, USA
  1. Correspondence to Wei Chen, Eye Hospital, Wenzhou Medical University, No. 270, West Xueyuan Road, Wenzhou, Zhejiang 325027, China; chenweimd{at}


Aims To compare the efficacy of compression sutures combined with intracameral air injection (CSAI) and thermokeratoplasty (TKP) for the management of acute corneal hydrops in keratoconus.

Methods In this multi-centre randomised clinical trial, 20 patients with keratoconus (20 eyes) with acute corneal hydrops were enrolled and randomised to receive either CSAI or TKP and followed-up for a period of 6 months.

Results There were no significant differences in patient demographics, severity of corneal hydrops and preoperative duration of symptoms between the two groups. In both groups, corneal oedema resolved within 2 weeks. The maximum thickness of the corneal scars following CSAI and TKP was not significantly different. Best spectacle-corrected visual acuity was superior in the CSAI group at 6-month follow-up (CSAI vs TKP, 0.52 (0.37, 0.85) vs 0.96 (0.70, 1.34) LogMAR, p=0.042). CSAI resulted in greater corneal endothelial cell density (CSAI vs TKP, 2677.8±326.7 vs 1955.3±298.1 cells/mm2, p<0.001) and flatter corneal curvature (CSAI vs TKP: mean keratometry value, 52.13±4.92 vs 63.51±5.83D, p<0.001; maximum keratometry value, 65.21±7.42 vs 77.13±12.01D, p=0.016) at the 6-month follow-up.

Conclusion Although both CSAI and TKP resulted in resolution of acute corneal hydrops in keratoconus, CSAI was associated with superior clinical outcomes in this study.

Chinese Clinical trial registration number ChiCTR-IOR-17013764

  • Cornea

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors ZZ, SW, WR, QZ and WC were involved in the study design and data collection. ZZ and MTMW analysed the data collected. ZZ, SW, CY, AK, VJ and WC prepared and revised the manuscript, and all authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available in a public, open access repository.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

Linked Articles

  • At a glance
    Frank Larkin