title: Primary diseases of corneal perforation in Shandong Province, China: a 10-year retrospective study.
abstract: OBJECTIVE
  To analyze primary diseases of corneal perforation in Shandong Province, China.
  
  
  METHODS
  Retrospective, noncomparative study.
  
  
  METHODS
  Medical records of 1,056 patients (1,080 eyes) with corneal perforation treated from January 1, 1997 through December 31, 2006 at Shandong Eye Institute were reviewed retrospectively, and primary diseases were evaluated.
  
  
  RESULTS
  Corneal perforations mainly were caused by ocular trauma 715 eyes (66.8%) and infectious keratopathy 294 eyes (27.5%). In the traumatic eyes, corneal penetrating wound accounted for 608 eyes (85.0%), followed by explosion injury 42 eyes (5.9%), thermal burn 34 eyes (4.8%), and chemical injury 29 eyes (4.1%). In the infectious eyes, the most common pathogens were herpes simplex virus 124 eyes (42.2%), fungus 74 eyes (25.2%), and bacterium 20 eyes (6.8%). Repeated corneal perforation occurred in nine eyes, with primary diseases of herpes simplex keratitis (HSK; four eyes), Mooren ulcer (two eyes), necrotizing keratitis and scleratitis (one eye), bacterial keratitis (one eye), and alkali burn (one eye). Corneal grafts perforated in 31 eyes, resulting from recurrent HSK (eight eyes), implant autoproteolysis (seven eyes), bacterial infections (six eyes), recurrent Mooren ulcer (four eyes), immunologic rejection (three eyes), trauma (two eyes), and fungal recurrence (one eye).
  
  
  CONCLUSIONS
  Ocular trauma and infectious keratopathy dominated among the primary diseases of corneal perforation in Shandong Province, China, during the past 10 years. HSK seems to be the most common cause of repeated corneal perforation. Recurrent primary diseases and implant autoproteolysis and infection more often result in graft perforation.
authors.affiliation: State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Qingdao, China. lixinxie@public.qd.sd.cn
authors.forename: Lixin
authors.initials: L
authors.lastname: Xie
authors.forename: Hualei
authors.initials: H
authors.lastname: Zhai
authors.forename: Xiaoguang
authors.initials: X
authors.lastname: Dong
authors.forename: Weiyun
authors.initials: W
authors.lastname: Shi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001753:Blast Injuries / Q000150:complications; D002057:Burns, Chemical / Q000150:complications; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D003316:Corneal Diseases / Q000150:complications* / Q000453:epidemiology; D065306:Corneal Injuries; D003320:Corneal Ulcer / Q000150:complications; D005126:Eye Burns / Q000139:chemically induced; D015817:Eye Infections / Q000150:complications; D005131:Eye Injuries / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D007223:Infant; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012421:Rupture