Spontaneous wound dehiscence after early suture removal after deep anterior lamellar keratoplasty.

PURPOSE: To describe a case of spontaneous wound dehiscence (WD) after complete suture removal in a patient with macular dystrophy who underwent deep anterior lamellar keratoplasty (DALK).

METHODS

A 47-year-old man with macular corneal dystrophy underwent DALK. Intraoperative Descemet membrane perforation was noted. The postoperative period was complicated by corneal edema and high astigmatism. Videokeratography-guided suture removal was carried out, and all sutures were removed by the end of 5 months after which the patient developed spontaneous 270° WD within 6 days. Visual acuity at the time of presentation in the affected eye was counting fingers, anterior chamber was formed, and intraocular pressure was normal. The wound was resutured with 17 interrupted sutures using 10-0 monofilament nylon under topical anesthesia.

RESULTS

Three months after resuturing, the best-corrected visual acuity was 6/9, and the graft-host junction was well apposed.

CONCLUSIONS

A spontaneous WD can be seen after complete removal of nonabsorbable suture during early months after DALK. Timely management can give good visual results.