Acute corneal hydrops treated with autologous stromal blood injection: in vivo confocal microscopy findings.

OBJECTIVE: To evaluate microstructural changes in the cornea of patients with acute corneal hydrops who underwent autologous blood injection using in vivo confocal microscopy (IVCM). METHODS: This prospective study included consecutive patients presenting with acute hydrops, who were treated with autologous blood injection. Patients were evaluated using slit-lamp biomicroscopy and IVCM at baseline, and 30 and 90 days after injection. RESULTS: Nineteen patients (12 males and 7 females) aged 10-52 years (mean: 21.9 ± 10.7 years) were included. The overall IVCM features were comparable to those previously described for acute corneal hydrops without surgical intervention. Hyper-reflective cells, presumed to be inflammatory cells, were observed during follow-up; however, no consistent structural abnormalities suggestive of treatment-related toxicity were identified during the study period. CONCLUSIONS: This study provides prospective serial IVCM characterization of eyes treated with intrastromal autologous blood for acute corneal hydrops. Within the limitations of a small cohort and short-term follow-up, no structural abnormalities suggestive of treatment-related toxicity were observed during the 90-day follow-up. Because this was a small, uncontrolled study, further comparative investigations are required to better define the clinical impact, benefits, and risks of this approach.