PMC4499622_01
Acute keratoconus with hydrops in a 3-year-old child with brittle cornea syndrome. (A) Left eye three months after acute keratoconus with already clearing corneal cloudiness. (B) Seven months after acute keratoconus only little subepithelial scars remained. (C) Optical coherence tomography (OCT) at 7 months after acute hydrops demonstrated steepness and thinning of cornea. Corneal thickness centrally was 259 mum.
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fig1
Seven months after acute keratoconus, corneal cloudiness was nearly completely cleared under local antibiotic and hyperosmolar treatment with only little subepithelial scars remaining (Figures 1(A) and 1(B)) and a visual acuity of 0.2 in the left eye. Optical coherence tomography (OCT) showed steepness of the cornea and a central pachymetry on the left side of now 259 mum (Figure 1(C)).
PMC4499622_02
Spontaneous corneal perforation in a child with brittle cornea syndrome. (A) For primary repair of the spontaneous corneal rupture of the right eye 4 corneal sutures were placed and the right eye was covered with a contact lens. (B) After suture removal, cornea healed and mild iris incarceration (arrow) persisted. (C) Optical coherence tomography (OCT) showed the iris incarceration (asterisk*) to be only adherent on the rear surface of the cornea (arrow). Corneal thickness was 289 mum.
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fig2
Spontaneous wound healing was observed using a bandage contact lens, systemic carboanhydrase inhibitor therapy, and ocular compression bandage for 7 days (Figure 2(A)). The pupil seemed rarely round, the optical axis was clear (Figure 2(B)), and fundus evaluation showed normal results. Using OCT, the iris incarceration was seen to be only adherent on the rear surface of the cornea (Figure 2(C)).
Intraoperative picture during surgical repair of spontaneous corneal rupture in brittle cornea. Note obvious cheese wiring (arrows) and attempt to maintain anterior chamber by intracameral air injection.
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fig3
Immediately there was cheese wiring (Figure 3) because of the extremely thin corneas of about 150-200 mum.