title: Acute Corneal Hydrops 3 Years after Intra-corneal Ring Segments and Corneal Collagen Cross-linking.
abstract: This case report describes a 15-year-old male with allergic conjunctivitis and keratoconus, who underwent uneventful intra-corneal ring segment (ICRS) implantation and corneal collagen cross-linking (CXL) in the right eye. During the follow-up periods, the patient was noted to have several episodes of allergic conjunctivitis that were treated accordingly. At the 2 years postoperatively, he presented with another episode of allergic conjunctivitis and progression of keratoconus was suspected on topography. However, the patient was lost to follow-up, until he presented with acute hydrops at 3 years postoperatively. There are no reported cases of acute corneal hydrops in cross-linked corneas. We suspect the young age, allergic conjunctivitis and eye rubbing may be a risk factors associated with possible progression of keratoconus after CXL. Prolonged follow-up and aggressive control of the allergy might be necessary in similar cases.
authors.affiliation: Department of Ophthalmology, American University of Beirut, Faculty of Medicine, Lebanon, United Arab Emirates.
authors.forename: Rafic
authors.initials: R
authors.lastname: Antonios
authors.affiliation: Department of Ophthalmology, Beirut Eye Specialist Hospital, Dubai, United Arab Emirates; Department of Ophthalmology, Saint-Joseph University, Faculty of Medicine Beirut, Lebanon, United Arab Emirates.
authors.forename: Ali
authors.initials: A
authors.lastname: Dirani
authors.affiliation: Department of Ophthalmology, Beirut Eye Specialist Hospital, Dubai, United Arab Emirates; Department of Ophthalmology, Saint-Joseph University, Faculty of Medicine Beirut, Lebanon, United Arab Emirates.
authors.forename: Ali
authors.initials: A
authors.lastname: Fadlallah
authors.affiliation: Department of Ophthalmology, Saint-Joseph University, Faculty of Medicine Beirut, Lebanon, United Arab Emirates.
authors.forename: Elias
authors.initials: E
authors.lastname: Chelala
authors.affiliation: Department of Ophthalmology, Beirut Eye Specialist Hospital, Dubai, United Arab Emirates.
authors.forename: Adib
authors.initials: A
authors.lastname: Hamadeh
authors.affiliation: Department of Ophthalmology, Beirut Eye Specialist Hospital, Dubai, United Arab Emirates; Department of Ophthalmology, Mediclinic, Dubai Mall, Dubai, United Arab Emirates.
authors.forename: Elias
authors.initials: E
authors.lastname: Jarade
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D003094:Collagen / Q000378:metabolism*; D015715:Corneal Edema / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D003319:Corneal Stroma / Q000378:metabolism / Q000601:surgery*; D019781:Corneal Topography; D003432:Cross-Linking Reagents; D006801:Humans; D007640:Keratoconus / Q000188:drug therapy / Q000378:metabolism / Q000601:surgery / Q000628:therapy*; D015948:Keratoplasty, Penetrating; D008297:Male; D010778:Photochemotherapy / Q000009:adverse effects*; D017319:Photosensitizing Agents / Q000627:therapeutic use; D019736:Prostheses and Implants; D019919:Prosthesis Implantation / Q000009:adverse effects*; D012256:Riboflavin / Q000627:therapeutic use; D014792:Visual Acuity / Q000502:physiology
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D003094:Collagen; D012256:Riboflavin
keywords: Acute Corneal Hydrops; Corneal Collagen Cross-linking; Intra-stromal Corneal Ring Segment; Keratoconus