title: Traumatic keratoplasty rupture resulting from continuous positive airway pressure mask.
abstract: OBJECTIVE
  To report a rare case of traumatic wound dehiscence caused by the use of a continuous positive airway pressure (CPAP) mask in a patient with chronic obstructive pulmonary disease (COPD) after penetrating keratoplasty (PKP).
  
  
  METHODS
  Observational case report.
  
  
  METHODS
  A 55-year-old man who was treated with uncomplicated PKP due to pellucid marginal corneal degeneration in the right eye 9 months earlier presented to the emergency department after a globe rupture caused by dislocation of his CPAP mask during sleep. The best-corrected visual acuity (BCVA) was light perception in the right eye. The corneal graft was dehisced from 12 over 3 to 6 o'clock (180 degrees) with interruption of the double running corneal sutures and nasal iris as well as vitreous incarceration. The graft was resutured in place with 33 interrupted 10-0 monofilament nylon sutures. The BCVA improved to 20/100 three months after globe reconstruction.
  
  
  CONCLUSIONS
  This case underlines the necessity of education for patients undergoing keratoplasty regarding the use of protective eyewear, to avoid predictable or accidental ocular injuries and graft dehiscence or its subsequent consequences. CPAP masks should be fitted (eyeball sparing) to the margins of the orbit after PKP.
authors.affiliation: Department of Ophthalmology, Saarland University Medical Center UKS, Homburg/Saar, Germany.
authors.forename: Miltiadis
authors.initials: M
authors.lastname: Fiorentzis
authors.forename: Berthold
authors.initials: B
authors.lastname: Seitz
authors.forename: Arne
authors.initials: A
authors.lastname: Viestenz
mesh_terms: D045422:Continuous Positive Airway Pressure / Q000295:instrumentation*; D003317:Corneal Dystrophies, Hereditary / Q000601:surgery; D065306:Corneal Injuries / Q000209:etiology* / Q000601:surgery; D006801:Humans; D015948:Keratoplasty, Penetrating; D008297:Male; D008397:Masks / Q000009:adverse effects*; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy; D012421:Rupture; D013529:Surgical Wound Dehiscence / Q000209:etiology* / Q000601:surgery; D013536:Suture Techniques; D014792:Visual Acuity