Traumatic globe rupture following penetrating keratoplasty

Abstract

Traumatic wound dehiscence may occur, and the prognosis is poor after the injury. Globe rupture at the graft-host junction showed persistence of wound weakness even a long time after PK. Prevention of ocular trauma should be performed following PK.

Traumatic wound dehiscence after penetrating keratoplasty

“…In the literature, crystalline lens or IOL damage is reported to be range from 37% [28] -100%, [29] and is accepted as a bad prognostic sign. In a study by Tran et al [31] , extensive dehiscence was more frequent in cases with lens and posterior segment damage. Other studies also support this finding, and damage to crystalline lens or IOL at presentation (commonly accompanied by posterior segment injury) has been proposed as a bad prognostic sign for final visual acuity in such eyes.…”

“…[14,19,[28][29][30][31] It has been noted that the most frequent indications in TWD are keratoconus, corneal scars, bullous keratopathy, herpetic keratitis, and Fuchs endothelial dystrophy. [4,11,14,[16][17][18][19][20]22,23,[25][26][27][28][29][30][31][32] In the present study, the most frequent PK indications were consistent with the general literature: corneal scar, keratoconus, leukoma, and bullous keratopathy. As these are most common indications for PK, [33] there are no definite data concerning the relationship between TWD and PK indications.…”

“…Likewise, other studies have also reported this region to be the most frequent site of wound separation. [16][17][18][19][20][25][26][27][28][29][30][31][32] The presence of sutures does not seem to protect against wound dehiscence, and there are differing reports about the effect of suturing techniques. [11,18,19,20,25,27] In our study group, interrupted suture was the most commonly used suturing technique, and in 16 (61.7%) eyes, all or some of the sutures were in place at the time of injury.…”

“…Especially in eyes with posterior segment damage, need for secondary surgical procedures has also been emphasized by other researchers. [20,31] The reported percentage of grafts remaining clear after TWD varies in a wide range between 20% [3] and 100%. [16,29] Although more endothelial cell loss is expected following trauma that is severe enough to cause lens/vitreous loss, due to some physiological transformation of endothelial cells following transplantation, long-term results following resuturing are usually satisfactory.…”

“…[4,11,14,18,20,22,23,25,27,31,34] Among our study population, we encountered secondary glaucoma, macular pucker, epithelial ingrowth with retinal detachment, fibrous ingrowth, and suprachoroidal hemorrhage.…”