case_images: PMC11801815_01
case_images: Clinical image and AS-OCT picture. AS-OCT: anterior segment optical coherence tomography. (A) Clinical image of the case of acute hydrops at presentation. (B) AS-OCT at presentation showing a single large hypodense intrastromal fluid pocket. (C) Clinical image at the first postoperative day. (D) AS-OCT at the first postoperative day showing compact stroma. (E) Clinical image at one-month follow-up with scar formation; the arrow shows a scar at the site of venting incision. (F) AS-OCT at one-month follow-up shows hyporeflective posterior corneal scar with the absence of stromal edema
case_images: cureus-0017-00000077049-i01.jpg
case_images: PMC11801815_01_cureus-0017-00000077049-i01.jpg
case_images: FIG1
case_images: On clinical examination, he had diffuse central corneal edema in the left eye (Figure 1A). AS-OCT of the left eye revealed stromal edema with a large stromal fluid cleft with no obvious break in DM (Figure 1B). There was an air bubble occupying three-fourths of the anterior chamber (Figure 1C). AS-OCT, the stromal lamellae were compact, and the stromal fluid pocket had nearly resolved (Figure 1D). At the one-month follow-up, the cornea remained clear with the formation of a paracentral corneal scar (arrow, Figure 1E). On AS-OCT, the cornea was compact with no fluid cleft and posterior corneal scar (Figure 1F).
case_images: Surgical step and Mi-OCT images at various surgical steps . Mi-OCT: microscope-integrated optical coherence tomography . (A) Localisation of intrastromal cleft. (B) Injection of intracameral gas. (C) Inferotemporal venting incision toward intrastromal fluid cleft. (D) Fluid expression (arrow) after creation of venting incision. (E) Polyvinyl acetal sponges used for soakage of egressed fluid. (F) At the end of the procedure, hypodense fluid cleft has minimized in volume
case_images: cureus-0017-00000077049-i02.jpg
case_images: PMC11801815_01_cureus-0017-00000077049-i02.jpg
case_images: FIG2
case_images: Intraoperatively, microscope-integrated OCT (Mi-OCT) helped to localize the stromal fluid cleft (Figure 2A). After 80% coverage of the anterior chamber, the incision was hydrated (Figure 2B). A venting incision was made using an angled microvitreoretinal blade from the inferotemporal quadrant of the cornea (Figure 2C). On reaching the targeted area, the blade was retracted back-creating a tract for fluid egression (Figure 2D). MA) (Figure 2E). Mi-OCT showed decreased intrastromal fluid cleft volume with a relatively compact stroma (Figure 2F).