Corneal tomography may help predict hydrops risk in keratoconus

Specific tomographic and clinical parameters—such as steeper keratometry, thinner corneas, and poorer visual acuity—can help identify keratoconus patients at higher risk of developing corneal hydrops, according toa. study.

In the study, researchers examined 55 eyes from 55 patients who had undergone corneal tomography before experiencing hydrops, comparing clinical and imaging data between affected and fellow eyes.

Most patients (90.9%) were contact lens users. Key findings included an average keratometry of 62.4 D, a maximum keratometry of 76.7 D, and a mean thinnest pachymetry of 285.4 microns before hydrops onset. Eyes that later developed hydrops showed significantly worse uncorrected visual acuity, steeper keratometry, and thinner corneas compared to the fellow eyes.

Multivariate analysis indicated that corneal crosslinking played a protective role in preventing hydrops, though its effect was not significant in eyes with paracentral cones. The authors suggest that these findings could contribute to a hydrops risk scoring system.

Reference
Sudanaboina P, Ali MH, Chaurasia S. Paired eye comparison of baseline parameters and tomographic characteristics prior to hydrops in patients with keratoconus. Int Ophthalmol. 2025;45(1):102. doi: 10.1007/s10792-025-03454-0. PMID: 40085273.