Management of circumferential mid-peripheral posterior membrane dehiscence causing hydrops in a child with posterior amorphous corneal dystrophy (PACD)

A boy in mid-childhood presented with diminished vision and corneal oedema in the right eye after blunt trauma. Visual acuity was hand motions in the right eye. Slit lamp examination showed diffuse corneal oedema with an area of relative translucency in the mid-peripheral region. The left eye had features characteristic of posterior amorphous corneal dystrophy (PACD). In the right eye, 15 radial corneal compression sutures were applied circumferentially over the posterior membrane defect. Corneal oedema resolved rapidly on postoperative day 1, with visual acuity of 20/125. Corneal clarity continued to improve, and visual acuity was 20/40 at the 4-month follow-up when all the sutures were removed. Serial documentation using optical coherence tomography and Scheimpflug imaging corroborated with clinical features. Circumferential mid-peripheral posterior membrane dehiscence occurring in PACD can be effectively managed with compression sutures to achieve favourable outcomes. Protective eyewear should be included in the management of such eyes.