Acute corneal hydrops is a vision-threatening complication of corneal ectatic disorders following sudden split of the Descemet membrane (DM) with ingress of aqueous into corneal stroma. Infection, pseudocyst formation, corneal perforation and neovascularization may ensue following long-standing edema. Reattachment of the retracted DM to the stroma with endothelial cell migration is pertinent for the healing process. Conservative management with topical hypertonic saline, steroids, and anti-glaucoma medications has been advocated. Descemetopexy with C₃F₈ and SF₆ is indicated in hydrops with small-sized tears. Full-thickness compression sutures with or without intracameral long-acting gases have been proposed, with favorable outcomes. Compression sutures act by shortening the edges of the DM split with anatomical reattachment. The orientation of the compression sutures is based on the presumed location of the posterior membrane split.