title: Clinical features of single and repeated globe rupture after penetrating keratoplasty.
abstract: BACKGROUND
  In this paper, we report our experience of the clinical features of single and repeated globe rupture after penetrating keratoplasty.
  
  
  METHODS
  We undertook a retrospective analysis of single and repeated globe ruptures following keratoplasty in eight eyes from seven consecutive patients referred to Kanazawa University Hospital over a 10-year period from January 2002 to March 2012. We analyzed their ophthalmic and demographic data, including age at time of globe rupture, incidence, time interval between keratoplasty and globe rupture, cause of rupture, complicated ocular damage, and visual outcome after surgical repair.
  
  
  RESULTS
  Five patients (71.4%) experienced a single globe rupture and two patients (28.6%) experienced repeated globe ruptures. Patient age at the time of globe rupture was 75.4 ± 6.8 (range 67-83) years. Four of the patients were men and three were women. During the 10-year study period, the incidence of globe rupture following penetrating keratoplasty was 2.8%. The time interval between penetrating keratoplasty and globe rupture was 101 ± 92 months (range 7 months to 23 years). The most common cause of globe rupture in older patients was a fall (n = 5, 79.8 ± 3.7 years, all older than 67 years). Final best-corrected visual acuity was >20/200 in three eyes (37.5%). In all except one eye, globe rupture involved the graft-host junction; in the remaining eye, the rupture occurred after disruption of the extracapsular cataract extraction wound by blunt trauma.
  
  
  CONCLUSIONS
  Preventative measures should be taken to avoid single and repeated ocular trauma following penetrating keratoplasty.
authors.affiliation: Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
authors.forename: Noriaki
authors.initials: N
authors.lastname: Murata
authors.forename: Hideaki
authors.initials: H
authors.lastname: Yokogawa
authors.forename: Akira
authors.initials: A
authors.lastname: Kobayashi
authors.forename: Natsuko
authors.initials: N
authors.lastname: Yamazaki
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Sugiyama
keywords: ocular trauma; penetrating keratoplasty; postoperative complications; repeated globe ruptures