PMC4759898_01
Corneal topography of right eye (a) before intra-corneal ring segment implantation, (b) 10 months post- and intra-corneal ring segment-collagen cross-linking procedures showing improvement of keratometry-readings. (c) Corneal topography of right eye at 2 years after intra-corneal ring segment implantation and corneal collagen cross-linking performed when the patient presented with exacerbation of allergic conjunctivitis, showing superior steepening with inferior flattening
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F1
OD (manifest refraction: -15.50 + 4.50 x 165) and 20/25 OS (manifest refraction: -7.10 + 5.00 x 60). On corneal topography (Pentacam, Oculus Optikgerate GmbH, Wetzlar, Germany), the keratometric values were 52.90/60.10 D and Kmax 65.10 D-right eye and in the left eye: 42.60/48.00 D with Kmax of 50.90 D [Figure 1a]. The thinnest pachymetry readings were 356 mm in the right eye and 398 mm in the left eye [Figure 1b]. Superior steepening with inferior flattening was present on topography, but the interpretation was not reliable because of the ocular surface conditions due to the severe allergic conjunctivitis associated with limbal hypertrophy [Figure 1c].
Slit-lamp photograph of the right eye 3 years post- and intra-corneal ring segment implantation and corneal collagen cross-linking. Surrounding the intra-corneal stromal ring is dense clouding involving around 60% of the cornea, consistent with acute corneal hydrops (note the yttrium aluminium garnet laser peripheral iridotomy between 1 and 2 o'clock, as the patient was prepared for implantable collamer lens implantation)
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F2
Examination revealed a dense cloudy thick cornea, with no signs of corneal perforation, corneal melting or ICRS migration [Figure 2].