{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:03:50Z","timestamp":1756425830387,"version":"3.44.0"},"reference-count":13,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,11,10]]},"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:p>A woman in her early 20s with progressive keratoconus underwent corneal collagen cross-linking using the sub400 protocol. The central 5.5\u2009mm of the epithelium was removed after the application of 20% alcohol. Topical riboflavin 0.1% was applied every 3\u2009min for 30\u2009min and then irradiated with UV-A light (irradiance of 3 mW\/cm<jats:sup>2<\/jats:sup> for 16\u2009min). At the end of the procedure, a therapeutic contact lens was placed and ofloxacin 0.3% (4 times daily), dexamethasone 0.1% (4 times daily) and lubricant (hourly) drops were prescribed.<\/jats:p>\n               <jats:p>Two days after the procedure, the patient presented with a painless red eye. A 360\u00b0 peripheral ring-like infiltrate was observed in the 5.5\u2009mm zone, consistent with a sterile infiltrate. Dexamethasone 0.1% drops were prescribed and tapered for 1\u2009month. Although the infiltrate gradually decreased under corticosteroid therapy, the patient\u2019s condition worsened after discontinuation of treatment. Treatment was resumed and complete recovery was observed 4 months later.<\/jats:p>","DOI":"10.1136\/bcr-2024-261923","type":"journal-article","created":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T21:50:29Z","timestamp":1733435429000},"page":"e261923","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Wessely-type immune ring following collagen cross-linking"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-1419-2499","authenticated-orcid":false,"given":"Mariana Domingues","family":"Vaz","sequence":"first","affiliation":[{"name":"Ophthalmology, Hospital Garcia de Orta EPE, Almada, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ines","family":"Machado","sequence":"additional","affiliation":[{"name":"Ophthalmology, Hospital Garcia de Orta EPE, Almada, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7949-7248","authenticated-orcid":false,"given":"Tom\u00e1s","family":"Loureiro","sequence":"additional","affiliation":[{"name":"Ophthalmology, Hospital Garcia de Orta EPE, Almada, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nuno","family":"Campos","sequence":"additional","affiliation":[{"name":"Ophthalmology, Hospital Garcia de Orta EPE, Almada, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,12,5]]},"reference":[{"key":"2025082803413748000_17.12.e261923.1","doi-asserted-by":"publisher","DOI":"10.1007\/s00417-018-3966-0"},{"key":"2025082803413748000_17.12.e261923.2","doi-asserted-by":"publisher","DOI":"10.1007\/s00347-012-2682-0"},{"key":"2025082803413748000_17.12.e261923.3","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1016\/j.survophthal.2023.02.009","article-title":"Wessely corneal ring phenomenon: An unsolved pathophysiological dilemma","volume":"68","author":"Ruiz-Lozano","year":"2023","journal-title":"Surv Ophthalmol"},{"key":"2025082803413748000_17.12.e261923.4","doi-asserted-by":"crossref","first-page":"154","DOI":"10.3928\/1081-597X-20030301-11","article-title":"Bilateral marginal sterile infiltrates and diffuse lamellar keratitis after laser in situ keratomileusis","volume":"19","author":"Ambr\u00f3sio","year":"2003","journal-title":"J Refract Surg"},{"key":"2025082803413748000_17.12.e261923.5","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/S0886-3350(96)80284-7","article-title":"Wessely-type immune ring following phototherapeutic keratectomy","volume":"22","author":"Teichmann","year":"1996","journal-title":"J Cataract Refract Surg"},{"key":"2025082803413748000_17.12.e261923.6","doi-asserted-by":"crossref","DOI":"10.3390\/jcm11030585","article-title":"Retrospective Analysis of Sterile Corneal Infiltrates in Patients with Keratoconus after Cross-Linking Procedure","volume":"11","author":"Krok","year":"2022","journal-title":"J Clin Med"},{"key":"2025082803413748000_17.12.e261923.7","doi-asserted-by":"crossref","DOI":"10.1186\/1752-1947-5-152","article-title":"Corneal melting after collagen cross-linking for keratoconus: a case report","volume":"5","author":"Labiris","year":"2011","journal-title":"J Med Case Rep"},{"key":"2025082803413748000_17.12.e261923.8","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1111\/aos.13218","article-title":"Sterile corneal infiltrates after corneal collagen cross-linking: evaluation of risk factors","volume":"95","author":"\u00c7erman","year":"2017","journal-title":"Acta Ophthalmol"},{"key":"2025082803413748000_17.12.e261923.9","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.1038\/eye.2014.173","article-title":"Sterile keratitis after combined riboflavin-UVA corneal collagen cross-linking for keratoconus","volume":"28","author":"Lam","year":"2014","journal-title":"Eye (Lond)"},{"key":"2025082803413748000_17.12.e261923.10","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1097\/ICO.0b013e318226da53","article-title":"Peripheral sterile corneal ring infiltrate after riboflavin-UVA collagen cross-linking in keratoconus","volume":"31","author":"Ghanem","year":"2012","journal-title":"Cornea"},{"key":"2025082803413748000_17.12.e261923.11","doi-asserted-by":"crossref","first-page":"609","DOI":"10.3928\/1081597X-20100326-01","article-title":"Corneal infiltrates after corneal collagen cross-linking","volume":"26","author":"Mangioris","year":"2010","journal-title":"J Refract Surg"},{"key":"2025082803413748000_17.12.e261923.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrs.2008.11.050"},{"key":"2025082803413748000_17.12.e261923.13","first-page":"2795","article-title":"Proinflammatory chemokine induction in keratocytes and inflammatory cell infiltration into the cornea","volume":"42","author":"Hong","year":"2001","journal-title":"Invest Ophthalmol Vis Sci"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-261923","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:41:45Z","timestamp":1756377705000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-261923"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12]]},"references-count":13,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12,5]]},"published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1136\/bcr-2024-261923"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-261923","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2024,12]]}}}