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Purpose Acute corneal hydrops is a sight-threatening complication of corneal ectasia caused by rupture of Descemet’s membrane (DM), leading to stromal oedema and visual loss. Surgical techniques using compression sutures with intracameral air or gas can accelerate resolution but carry risks including raised intraocular pressure, pupil block, cataract formation, and further DM trauma. We evaluated the safety and efficacy of partial-thickness compression sutures without intracameral air tamponade for the management of acute corneal hydrops.Methods A retrospective case series was conducted at a tertiary corneal centre. Seven eyes from six patients with acute hydrops secondary to corneal ectasia underwent partial-thickness (approximately 90%) 10-0 nylon compression sutures without intracameral air or gas. Demographic data, best-corrected visual acuity (BCVA), central corneal thickness (CCT), and anterior segment OCT findings were analysed pre- and post-operatively. Time to corneal oedema resolution and complications were recorded.Results The median age was 29 years (range 17–64). Five eyes had keratoconus and two had pellucid marginal degeneration. Median time to corneal oedema resolution was one month (range one week to three months), significantly shorter than expected with conservative management. Mean CCT reduced from approximately 1000 μm at presentation to 600 µm at one week and 500–550 µm by one to three months in resolved cases. BCVA improved in six of seven eyes. No intraocular complications, including infection, raised intraocular pressure, or cataract formation, were observed.Conclusion Partial-thickness compression sutures without intracameral air tamponade appear to be a safe and effective surgical option for acute corneal hydrops, achieving rapid oedema resolution while avoiding air-related and full-thickness suture complications. This technique may preserve corneal integrity and improve outcomes for future keratoplasty.