title: [Characteristics of traumatic versus spontaneous wound dehiscence after penetrating keratoplasty].
abstract: OBJECTIVE
  After penetrating keratoplasty (PK) patients remain at risk for wound dehiscence at the graft-host junction even years after surgery. The aim of our study was, firstly, to assess the site-specific characteristics between traumatic and spontaneous wound dehiscence at the graft-host junction and, secondly, to determine the incidence of traumatic and spontaneous wound dehiscence.
  
  
  METHODS
  The medical records of all 243 patients who underwent a penetrating keratoplasty from 1 March 1996 to 1 March 2012 were retrospectively reviewed. During a 16-year period 9 eyes showed signs of open wound dehiscence after blunt ocular trauma and 7 eyes spontaneously after suture removal.
  
  
  RESULTS
  Over the 16-year period, the incidence of traumatic wound dehiscence was 3.7 % (9 of patients), whereas the incidence of spontaneous wound dehiscence after suture removal was 2.9 % (7 of 243 patients). In traumatic cases the graft dehiscence occurred in 88.9 % (8 of 9 patients) in the nasal part, predominantly in the inferior nasal part. In one case (11.1 %), only the temporal part was affected. The average extent of wound dehiscence for traumatic cases was 96° of the total wound circumference in the nasal part, and only 30° of the circumference in the temporal part. Spontaneous dehiscence after suture removal mainly occurred at temporal site in 71.4 % (5 of 7 eyes), mostly temporal inferior. Only in one case was the nasal part affected (14.3 %). The average extent of wound dehiscence in spontaneous cases was 54° of the total circumference in the temporal part and 21° in the nasal part. The total average extent of dehiscence was significantly larger in traumatic cases, 126° (one third) for traumatic and 75° (one fifth) of the wound circumference for spontaneous cases. All of the re-sutured grafts retained clarity, except for 3 eyes among the traumatic cases.
  
  
  CONCLUSIONS
  The difference between both groups was significant regarding the localisation, the extent and the clarity of the re-sutured grafts. The nasal inferior part was the most affected area in traumatic cases probably as a result of indirect, contrecoup injuries, and the temporal part in spontaneous wound dehiscence probably due to direct minor forces.
authors: Department of Ophthalmology, University Clinical Centre Maribor, Faculty of Medicine, University of Maribor, Slovenia. d.pahor@sb-mb.si
authors: D
authors: D
authors: Pahor
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D015897:Comorbidity; D005131:Eye Injuries / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D015948:Keratoplasty, Penetrating / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D017524:Slovenia / Q000453:epidemiology; D013529:Surgical Wound Dehiscence / Q000175:diagnosis / Q000453:epidemiology*; D013536:Suture Techniques / Q000706:statistics & numerical data*; D014950:Wounds, Penetrating / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult