Traumatic wound dehiscence after penetrating keratoplasty—a cause for concern

Abstract

Aim We report the incidence, causes, characteristics, and the outcome of traumatic corneal graft ruptures in a tertiary referral centre in the UK. Method A retrospective analysis of all graft ruptures secondary to trauma that were treated at our centre between 1999 and 2005 was undertaken. Statistical analysis of possible prognostic factors was undertaken using the Fisher's test.

Traumatic Wound Dehiscence After Penetrating Keratoplasty

“…For this reason, wound dehiscence after trauma commonly occurs at graft-host junction. [2][3][4]7,9,10,16] In the present study, all graft dehiscences occurred at graft-host interface, a finding consistent with the literature.…”

“…[1,[4][5][6][7][8][9][10] Incidence was reported to be 1.5% in our previous case series consisting of 6 eyes in 398 PK eyes. [18] The first year --and especially the first month --is reported to be the most vulnerable period for traumatic wound dehiscence after PK.…”

“…[10,11,19] Suture removal weakens wound integrity and risk for wound dehiscence increases significantly. [10] In the present series, 70.5% of graft dehiscences occurred in postoperative 18 months, and 23.5% of graft dehiscence took place within the first 6 months of suture removal. Some authors report that grafts with intact sutures tend to have a smaller degree of dehiscence, but we did not find such a relationship in this case series.…”

“…[2,3] Incidence of traumatic wound dehiscence after PK has been reported as between 0.6% and 5.8%. [1,[4][5][6][7][8][9][10] This complication generally occurs within first 2 years after PK, and may lead to delayed visual rehabilitation and increased risk of corneal graft edema and rejection. [4,6,[11][12][13][14] …”

Traumatic wound dehiscence after penetrating keratoplasty

“…[13,18] In the literature, occurrences of traumatic graft rupture have been reported from 3 days to 33 years after PK. [18,21,22] Thirtythree years is the longest reported time interval after PK, indicating a lifetime risk of traumatic dehiscence. The mean time interval between PK and TWD was 17.7 months in our study group, and in 15 (57.7%) cases, trauma had occurred within the first postoperative year.…”