This report highlights a rare case of acute hydrops in a host cornea that developed 7 years after penetrating keratoplasty (PKP) for keratoconus. We obtained detailed clinical findings of the condition by anterior segment optical coherence tomography (AS-OCT). We believe this is the first report of hydrops localized in the host cornea without causing edema in the graft. In addition, its onset was the earliest observed after keratoplasty [1-4]. Case reportA 37-year-old man had been followed up by a local doctor for keratoconus since 1995. The patient developed acute hydrops in his right eye in 2001 and was referred to our hospital by the local doctor. The acute hydrops improved spontaneously after 2 months. His best corrected visual acuity (BCVA) oculus dexter (OD) with a hard contact lens (HCL) recovered to 1.2. Later, the patient developed acute hydrops OD twice, and his BCVA decreased to 0.2. He underwent PKP in his right eye at our hospital in 2003. In 2005, he underwent PKP in his left eye because of HCL intolerance due to an exacerbation of the keratoconus. In 2009, his BCVA with HCL was 1.5 oculus uterque (OU). The graft and host cornea OU were clear. The corneal endothelial cell density (ECD) was 573 cells/mm 2 OD and 871 cells/mm 2 oculus sinister (OS); the central corneal thickness (CCT) was 610 lm OD and 590 lm OS. The patient revisited our hospital in January 2010 complaining of corneal opacity in the nasal side of the right eye and HCL intolerance. Despite decentration of the HCL to the nasal side, VA OD was 1.2. Although slit-lamp microscopy revealed corneal opacity and thickening of the lower nasal side of the host cornea, the graft was transparent, and no inflammatory or rejection findings were observed (Fig.

There was a dissociation in response between flare and cells in the aqueous to intracameral endotoxin. The minimum endotoxin concentration causing inflammation ranged between 0.23 and 0.60 EU.

This is the first recorded case of Capnocytophaga keratitis in Japan. Patients with dementia may develop severe ocular complications after infectious keratitis because of their inability to communicate.