Inverse relationship between age and severity and sequelae of acute corneal hydrops associated with keratoconus

Corneal collagen crosslinking in children with keratoconus

“…It is recognized that there is an inverse relationship between age and severity of keratoconus 6 and that the disease presents at a more advanced stage (27.8% being stage 4 compared with 7.8% of adults) 7 and progresses more frequently and rapidly with subsequent advanced vision loss. 7,12 There is also an inverse relationship between age and risk of development of acute hydrops, as demonstrated by Suhaibani and colleagues, 13 and younger age is recognized as an independent risk factor for requiring penetrating keratoplasty in keratoconus. [14][15][16] Corneal biomechanical rigidity is weaker at a younger age 17 ; this may contribute to the severity of progression of the disease in children.…”

Postoperative Complications After Primary Adult Optical Penetrating Keratoplasty: Prevalence and Impact on Graft Survival

“…The occurrence of peripheral vascularization in chronically inflamed eyes with aphakic or pseudophakic corneal edema is also well established. Conversely, peripheral corneal vascularization is generally absent in eyes with stromal dystrophies and in those with keratoconus, unless the clinical course has been complicated by hydrops 80,81 or concomitant VKC. 63,82 Glaucoma worsening is the leading cause of irreversible visual loss after PKP attributable to optic nerve damage.…”

A prospective study of acute corneal hydrops by in vivo confocal microscopy in a New Zealand population with keratoconus

“…These longstanding clinical impressions appear consistent with the data in the current prospective study. Variation in the severity of acute hydrops and subsequent corneal neovascularisation have also been reported in other ethnic groups, such as Saudi Arabian and Indian populations 6 15…”

“…Both presented with corneal oedema extending close to the limbus; however, three other cases with similarly extensive oedema did not develop neovascularisation. Previous studies suggest that oedema near the limbus and intrastromal cleft formation in cases of acute corneal hydrops may be considered risk factors for subsequent stromal neovascularisation 15 22 23. Any associated inflammatory response, which may be greater in patients with atopy, has also been suggested as a potential stimulus to neovascularisation 23…”