Traumatic wound dehiscence after corneal graft.

BACKGROUND AND

OBJECTIVE

Any trauma to a corneal transplanted eye is likely to lacerate the corneal wound because of persistent wound weakness, even years after keratoplasty. We evaluate the risks and consequences of trauma after penetrating keratoplasty (PKP).

METHODS

Records of 11 patients who had been treated in our department from 1992 to 1998 for traumatic wound dehiscence after PKP were reviewed for the type of insult, visual acuity, operative methods, and outcome.

RESULTS

The period between corneal grafting and wound rupture ranged from two months to three years. In 9 patients, the sutures were still in place. All the ruptures occurred at the donor-recipient interface. In 5 patients, the rupture was in the inferior half of the wound, in another 5 patients in the superior half, and in 1 patient it was nasal. In all the patients, the extent of the rupture was over 120 degrees and the lens was effected. All the patients had posterior segment involvement, the extent of which was related to the visual outcome. One eye was enucleated, another eye regrafted, and 8 of the remaining 9 grafts were restored and remained transparent.

CONCLUSIONS

Despite severe trauma, most of the grafts' clarity can be restored, and good visual results can be achieved.