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cases (Table 1) of nonresolving corneal hydrops in cases of keratoconus with corneal edema that was more severe than that in the current study (66.7% of cases had corneal thickness .1600 mm) with excellent outcomes (median resolution time—17.5 6 8.4 d; repeat procedure— none; intraoperative or postoperative complications—none). The basic steps of our technique are similar to what the authors have described. However, we used an micro-vitreo retinal blade instead of a 30-gauge cannula for drainage of fluid pockets. We avoided any stromal pocket that was in direct communication with the anterior chamber because of a torn DM to avoid formation of a corneal fistula. We performed multiple punctures rather than 1 to drain each stromal fluid pocket. Besides, external massage was performed with Merocel sponges, which had an added advantage of absorbing the fluid by capillary action. In the setting of acute corneal hydrops, where the cornea is edematous, it may not always be possible to compress the cornea enough to allow the torn DM to reattach completely. This is highlighted by the persistent DM detachment in case 1 of the current study. The compression suture, especially when the DM is torn, may act as a conduit for infection because it is in direct communication with the external surface of the cornea. It increases the risk of postoperative infection, especially when the cornea is compromised and steroids are an inevitable component of the treatment regimen. Removal of these sutures, especially when patients have systemic associations such trisomy 21, requires a second intervention under general anesthesia. In addition, the site of the sutures being in the central visual axis may result in additional corneal scarring that may further compromise the final visual outcome in these cases. Thus, we believe putting compression sutures in all cases of corneal hydrops may not give an added advantage, but we agree with the authors that MI-OCT is an extremely useful tool in such circumstances. In addition, the technique of intrastromal punctures hastens the resolution of corneal edema in such cases. However, we find that there are some limitations of MI-OCT such as reflectivity of needle/cannula/micro-vitreo retinal which often make the assessment of exact depth of the instrument difficult by obscuring the underlying view. Financial disclosures/conflicts of interest: None reported.