Termoqueratoplastia y trasplante de membrana amniótica como tratamiento del hidrops corneal refractario en un paciente con degeneración marginal pelúcida

A 57-year-old male presented to our clinic with acute corneal hydrops. He had been diagnosed with pellucid marginal degeneration (PMD) three years before. Since conservative treatment and intracameral air injections failed to resolve the corneal edema, we decided to perform a thermokeratoplasty (TKP) plus an amniotic membrane transplantation (AMT). Two weeks after the procedure the patient did not have any pain, corneal edema resolved, and best corrected visual acuity (BCVA) improved from counting fingers to 1 logMAR. During the two-year follow-up the patient has remained asymptomatic, at the 2-year follow-up, BCVA is 0.2 logMAR, corneal steepness has reduced in inferior perifery from 71.3 diopters (D) down to 56.7 D and just a mild leukoma remains at the original hydrops presentation site.

TKP combined with AMT should be considered as a treatment option in acute corneal hydrops, especially in patients with peripheral location as PMD, uncompliant patients, and refractory cases.