Ruptured globe 20 years after radial and transverse keratotomy

Abstract

To report a case of corneal rupture due to blunt trauma occurring 20 years after radial keratotomy (RK) and transverse keratotomy. A 57-year-old woman sustained direct blunt trauma to her right eye. Ocular examination revealed a ruptured globe involving two of the eight RK incisions connected together across the visual axis with iris incarceration in the wound. The transverse keratotomy scars remained intact. The patient underwent primary corneal wound repair and iris repositioning. The postoperative period was uneventful. The patient had a visual acuity of counting fingers at 1 m and is awaiting penetrating keratoplasty. Traumatic rupture of RK incisions can still occur after 20 years. Patients having undergone RK many years before should be warned of a possible life-long risk of traumatic rupture. RK scars appear to be more vulnerable to rupture than astigmatic keratotomy scars.

When case report became case series: 45 cases of late traumatic flap complications after laser-assisted in situ keratomileusis and review of Chinese literature

“…Poor results were often associated with severe injury, other eye injuries and delayed treatment. Unlike radial keratotomy (RK), where traumatic rupture of RK incisions can still occur after 20 years and there may be serious complications,17 ocular integrity after LASIK did not decrease as Peacock's study showed 18. Exaggeration of late traumatic flap complications after LASIK equal to those of RK is therefore unwise.…”

Management of traumatic wound dehiscence of a functional graft 34 years after penetrating keratoplasty

“…Wound dehiscence has also been reported after deep anterior lamellar keratoplasty,2 cataract surgery,3 penetrating globe injury and radial keratotomy 4. Trauma is the most common cause for dehiscence followed by early suture removal2 and increased intraocular pressure.…”