title: Outcomes of Wound Dehiscence Post-Penetrating Keratoplasty.
abstract: OBJECTIVE
  Penetrating keratoplasties (PKs) carry a lifetime risk of developing wound dehiscence, which can lead to severe consequences to vision. To better understand the risk, we analyzed the characteristics and outcomes of a series of patients with wound dehiscence post-PK.
  
  
  METHODS
  Data were collected retrospectively on 31 eyes from 30 patients with a history of wound dehiscence repair post-PK between January 1, 2009, and April 30, 2014, and followed up at the Cornea Service at Wills Eye Hospital. Only patients who had surgical repair of an open wound dehiscence were included, excluding those with wound slippage but no aqueous leak.
  
  
  RESULTS
  The mean age at wound dehiscence was 56 years with a mean time from PK to dehiscence of 9.8 years. Among the 31 eyes, 26 (26/31, 84%) had trauma-induced dehiscence, while 5 had unknown causations or no reported trauma. The mean size of dehiscence was 153 ± 66 degrees. Visual outcomes ranged from 20/50 to no light perception, with a majority between 20/100 and hand motion (18/30, 60%). Twenty eyes (20/26, 76%) lost their lens at dehiscence. All 10 phakic eyes lost their lenses. Five patients retained their lens implants and had a better mean visual outcome (average = 20/400) than the 10 patients who lost their implants (average = 20/800) (1 lens status was unknown postdehiscence).
  
  
  CONCLUSIONS
  Wound dehiscence is a lifelong risk after PK regardless of the age, indication for corneal transplant, and time since transplant. A better visual outcome was associated with retained pseudophakia and clear corneas.
authors.affiliation: *Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA; and †Cornea Service, Wills Eye Hospital, Philadelphia, PA.
authors.forename: Jenny F
authors.initials: JF
authors.lastname: Ma
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Rapuano
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Hammersmith
authors.forename: Parveen K
authors.initials: PK
authors.lastname: Nagra
authors.forename: Yang
authors.initials: Y
authors.lastname: Dai
authors.forename: Amir A
authors.initials: AA
authors.lastname: Azari
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003316:Corneal Diseases / Q000601:surgery; D005260:Female; D006801:Humans; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013529:Surgical Wound Dehiscence / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D013997:Time Factors; D014792:Visual Acuity; D014945:Wound Healing; D055815:Young Adult