Abstract
Purpose
To evaluate the mechanism, clinical characteristics, management and visual outcome of ocular trauma following penetrating keratoplasty (PK).
Methods
Twenty-six patients (13 men, 13 women) who suffered surgical wound dehiscence after PK because of ocular blunt trauma between 1994 and 2001 were included in this retrospective study. Graft dehiscence was managed with primary wound closure in all patients. Visual acuity, intraocular pressure, and funduscopy were evaluated in the follow-up.
Results
The mean age at trauma was 50±24 years (range 9–88 years). Mean interval between transplantation and trauma was 45.5±64 months (range 1 month to 20 years). Globe rupture occurred at the graft–host junction in all patients. Nine of 13 phakic eyes (69.2%) presented lens expulsion. Eight of nine pseudophakic eyes (88.9%) had lost their implants. Retinal detachment occurred in seven eyes (27%) within 3 months following the trauma. Five patients (19.2%) underwent vitreous surgery for posterior segment damage. Two eyes (7.7%) were regrafted. At the last examination, only seven eyes (27%) had visual acuity of 20/200 or better.
Conclusions
Traumatic wound dehiscence may occur, and the prognosis is poor after the injury. Globe rupture at the graft–host junction showed persistence of wound weakness even a long time after PK. Prevention of ocular trauma should be performed following PK.
Similar content being viewed by others
References
Abou-Jaoude E, Brooks M, Katz D, Van Meter W (2002) Spontaneous wound dehiscence after removal of single continuous penetrating keratoplasty suture. Ophthalmology 109(7)
Agrawal V, Wagh M, Krishnamachary M, Rao GN, Gupta S (1995) Traumatic wound dehiscence after penetrating keratoplasty. Cornea 14:601–603
Binder PS, Abel RJ, Polack FM, Kaufman HE (1975) Keratoplasty wound separations. Am J Ophthalmol 80:109–115
Bowman RJ, Yorston D, Aitchison TC, McIntyre B, Kirkness CM (1999) Traumatic wound rupture after penetrating keratoplasty in Africa. Br J Ophthalmol 83:530–534
Calkins JL, Hochheimer BF, Stark WJ (1981) Corneal wound healing: holographic stress-test analysis. Invest Ophthalmol Vis Sci 21:322–334
Cherry PMH (1972) Rupture of the globe. Arch Ophthalmol 88:498
Farley MK, Pettit TH (1987) Traumatic wound dehiscence after penetrating keratoplasty. Am J Ophthalmol 104:44–49
Friedman AH (1973) Late traumatic wound rupture following successful partial penetrating keratoplasty. Am J Ophthalmol 75:117–120
Gasset AR, Dohlman CH (1968) The tensile strength of corneal wounds. Arch Ophthalmol 79:595–602
Luttrul J, Jester JV, Smith RE (1988) The effect of radial keratotomy on ocular integrity in an animal model. Arch Ophthalmol 100:319–320
Oshry T, Lifihitz T (2001) Traumatic wound dehiscence after corneal graft. Ophthalmic Surg Lasers 32:470–473
Raber, IM, Arentsen JJ, Laibson PR (1980) Traumatic wound dehiscence after penetrating keratoplasty. Arch Ophthalmol 98:1407–1409
Rehany U, Rumelt S (1998) Ocular trauma following penetrating keratoplasty: incidence, outcome, and postoperative recommendations. Arch Ophthalmol 116:1282–1286
Rohrbach JM, Weidle EG, Steuhl KP, Meilinger S, Pleyer U (1996) Traumatic wound dehiscence after penetrating keratoplasty. Acta Ophthalmol Scand: 74:501–505
Topping TM, Stark WJ, Maumenee E, Kenyon KR (1982) Traumatic wound dehiscence following penetrating keratoplasty. Br J Ophthalmol 66:174–178
Tseng SH, Lin SC, Chen FK (1999) Traumatic wound dehiscence after penetrating keratoplasty: clinical features and outcome in 21 cases. Cornea 18:553–558
Sharma S, Saffra NA, Chapnick EK (2003) Post traumatic polymicrobial endophthalmitis, including Neisseria subflava. Am J Ophthalmol 136:554–555
Author information
Authors and Affiliations
Corresponding author
Additional information
None of the authors has any financial interest in this study
Rights and permissions
About this article
Cite this article
Tran, T.H.C., Ellies, P., Azan, F. et al. Traumatic globe rupture following penetrating keratoplasty. Graefe's Arch Clin Exp Ophthalmol 243, 525–530 (2005). https://doi.org/10.1007/s00417-004-1066-9
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00417-004-1066-9