gms | German Medical Science

Blunt ocular trauma to a corneal transplanted eye represents a higher risk for wound rupture at the donor-recipient interface. We evaluate the causes, clinical characteristics, treatment and outcome, particularly the graft’s clarity in patients with traumatic wound dehiscence after penetrating keratoplasty.

Between March 1996 and April 2006, over a period of 10 years, 4 patients who had previously undergone successful penetrating keratoplasty and subsequently sustained traumatic wound dehiscence were treated at our department. All eyes underwent primary wound closure with interrupted 10-0 nylon sutures.

Over the 10-year period, the incidence of traumatic wound dehiscence in which penetrating keratoplasty was performed was 2.35% (4 of 170 patients). The age of our patients at the time of injury was 6, 39, 76 and 78 years. The interval between penetrating keratoplasty and trauma varied from 12, 16, 17 to 30 months. All corneal dehiscence occurred at the graft-host junction without particular site or quadrant preference. Two eyes that were pseudophakic had lost their implants and required anterior vitrectomy. In one of these patients (a 76-year-old woman) delayed-onset expulsive choroidal hemorrhage occurred at the end of surgical repair. Visual outcome was defined with force of trauma, previous eye conditions and complication during surgery. All of the resutured grafts retained clarity.

Traumatic wound dehiscence is a serious and not rare complication following penetrating keratoplasty. Despite severe trauma, graft transparency was achieved in all cases and there was no need for regrafting.