Traumatic wound dehiscence after deep anterior lamellar keratoplasty.
We report the case of a 12-year-old boy with severe keratoconus who had uneventful deep anterior lamellar keratoplasty (DALK) using the big-bubble technique in the left eye for severe loss of best spectacle-corrected visual acuity and contact lens intolerance. Two weeks after surgery, the patient experienced accidental blunt trauma to the operative eye and developed a traumatic 180-degree superior wound dehiscence of the lamellar graft without perforation into the anterior chamber. The DALK technique provided adequate tectonic support to prevent a ruptured globe throughout the traumatic event in contrast to penetrating keratoplasty, which can lead to devastating vision damage after blunt trauma. The traumatic wound dehiscence was repaired without entry into the anterior chamber, and the patient had a successful, quick recovery in visual acuity with no permanent damage to the eye.
Lee
W Barry
WB
Eye Consultants of Atlanta, Cornea and External Disease Section, Atlanta, Georgia, USA. lee0003@aol.com
Mathys
Kenneth C
KC
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D065306:Corneal Injuries; D016039:Corneal Transplantation; D004359:Drug Therapy, Combination; D005131:Eye Injuries / Q000209:etiology*; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007640:Keratoconus / Q000601:surgery*; D008297:Male; D013529:Surgical Wound Dehiscence / Q000209:etiology* / Q000601:surgery; D013536:Suture Techniques; D014792:Visual Acuity; D014949:Wounds, Nonpenetrating / Q000209:etiology*
D000900:Anti-Bacterial Agents; D005938:Glucocorticoids