Traumatic globe rupture following penetrating keratoplasty.
OBJECTIVE
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.
Tran
Thi Ha Chau
TH
Department of Ophthalmology, Hôpital Hotel-Dieu de Paris, 1 Place Parvis de Notre-Dame, 75004, Paris, France. tranhachau@hotmail.com
Ellies
Pierre
P
Azan
Frédéric
F
Assaraf
Eric
E
Renard
Gilles
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003316:Corneal Diseases / Q000601:surgery; D005131:Eye Injuries / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D012421:Rupture; D013529:Surgical Wound Dehiscence / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D013536:Suture Techniques; D013997:Time Factors; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014792:Visual Acuity; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D055815:Young Adult