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Acute hydrops occurs in approximately 3% of eyes with keratoconus.1 The incidence increases dramatically in eyes with associated vernal keratoconjunctivitis.2,3 Neovascularisation rarely develops after resolution of acute hydrops although it has been reported with large area of involvement with hydrops associated with either close proximity to the limbal vascular arcades4 or intrastromal clefts.5 The association between patient age and area of involvement of hydrops, with the subsequent risk of development of neovascularisation, has not been adequately addressed in a prospective clinical trial.
In Saudi Arabia, patients present with severe keratoconus at a much younger age than in Western populations and have a higher incidence of associated atopic eye disease.2,3 The average age at the time of penetrating keratoplasty in our patient population is 19 years, with …
Competing interests: None.
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