JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY) ›› 2018, Vol. 32 ›› Issue (2): 95-98.doi: 10.6040/j.issn.1673-3770.0.2017.279

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Traumatic wound dehiscence after penetrating keratoplasty: eight cases and a literature view

WANG Juan, ZHAO Min, XU Mei, ZHANG Qi, ZHOU Shanbi   

  1. Department of Ophthalmology, the First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of
  • Received:2017-06-23 Online:2018-03-20 Published:2018-03-20

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Abstract: Objective To analyze the patient characteristics, risk factors, complications, and visual outcomes of traumatic wound dehiscence after penetrating keratoplasty and to highlight the importance of prevention of trauma after penetrating keratoplasty. Methods We retrospectively reviewed the medical records at our institution from 2014 to 2015 and identified 8 eyes(8 patients)who had undergone penetrating keratoplasty followed by traumatic wound dehiscence. A review of the PubMed database identified reports on 49 further eyes(49 patients), giving a total of 57 eyes(57 patients). Results The 57 affected eyes were in patients of mean age 39.86±17.63 years. The mean duration between the data of penetrating keratoplasty and the trauma was 23.05±15.99 months. The associated anterior segment injuries included prolapse of the lens/intraocular lens in 26 eyes, prolapse of the iris in 22 eyes, and hyphema in 19 eyes. The associated posterior segment injuries included prolapse of the vitreous in 18 eyes, vitreous hemorrhage in 17 eyes, retinal detachment in 8 eyes, and suprachoroidal hemorrhage in 3 eyes. After traumatic wound dehiscence, 1 patient had endophthalmitis and 1 patient developed proliferative vitreoretinopathy. Best-corrected visual acuity was 0.1 or better in 21 eyes, better than hand motion to less than 0.1 in 13 eyes, hand motion or light perception in 15 eyes, and no light perception in 8 eyes after retreatment. Injury of the limbs and different objects was the most common cause of wound dehiscence. Conclusion Patients who undergo penetrating keratoplasty have a life-long risk of wound dehiscence, regardless of age, indication for penetrating keratoplasty, and time since penetrating keratoplasty. Wound dehiscence is more likely to occur after trauma, particularly in the first year after penetrating keratoplasty. Most patients have a poor visual outcome. Absence of serious eye complications and posterior segment injury is associated with a better visual outcome.

Key words: Penetrating keratoplasty, Trauma, Wound dehiscence

CLC Number: 

  • R779.1
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