Thermokeratoplasty and amniotic membrane transplantation for refractory corneal hydrops in a patient with pellucid marginal degeneration.

A 57-year-old male presented at our clinic with acute corneal hydrops. He had been diagnosed with pellucid marginal degeneration (PMD) three years before. Conservative treatment as well as intracameral air injections failed to resolve the corneal edema, so we decided to perform a thermokeratoplasty (TKP) associated with an amniotic membrane transplantation (AMT). Two weeks after the procedure the patient did not report having any pain, corneal edema resolved, and best spectacle corrected visual acuity (BSCVA) improved from counting fingers to 1 logMAR. During the two-year follow-up the patient has been asymptomatic, BSCVA is 0.2 logMAR, corneal steepness has reduced in inferior perifery from 71.3 diopters (D) to 56.7 D and just a mild leukoma is present at the original hydrops presentation site. TKP combined with AMT should be considered as a treatment option in acute corneal hydrops, especially in those with peripheral location as PMD, uncompliant patients, and refractory cases.