Outcomes of Wound Dehiscence after Penetrating Keratoplasty and Lamellar Keratoplasty

Objective To investigate the incidence, causes, occurrence time, and range of wound and outcomes of wound dehiscence in patients treated by penetrating keratoplasty (PK) or lamellar keratoplasty (LK). Methods We retrospectively reviewed medical records of keratoplasty in Shandong Eye Hospital from January 2006 to June 2017. Thirty-one eyes of 30 patients had sustained wound dehiscence (WD) after surgical treatment. The surgical type, causes, occurrence time, extent of the wound, treatment, and outcomes were recorded. Results The study population consisted of 26 men and 4 women. The mean age at the occurrence of WD was 44.6 years old (range: 12–78 years), and the mean time from keratoplasty to WD was 45.9 months (range: 1–204 months). WD occurred in 23 eyes (23/1385, 1.66%) after PK and 8 eyes (8/1632, 0.49%) after LK (p < 0.05). Twenty-seven eyes (27/31, 87.0%) had trauma-induced dehiscence. The mean range of dehiscence was 5.5 o'clock. The vision ranged from 20/50 to light perception after wound suture. The eyes receiving LK had fewer serious complications than PK. Conclusions Compared with LK, PK seems to be more prone to result in wound dehiscence. The WD after LK may be less severe. The visual acuity after treatment of WD can be worse in the eyes with PK than LK.

[1]  C. Rapuano,et al.  Outcomes of Wound Dehiscence Post–Penetrating Keratoplasty , 2016, Cornea.

[2]  C. McGhee,et al.  Incidence, severity and outcomes of traumatic wound dehiscence following penetrating and deep anterior lamellar keratoplasty , 2016, British Journal of Ophthalmology.

[3]  W. Hida,et al.  Traumatic wound dehiscence after corneal keratoplasty. , 2015, Arquivos brasileiros de oftalmologia.

[4]  H. Helaly,et al.  Traumatic Wound Dehiscence after Keratoplasty: Characteristics, Risk Factors, and Visual Outcome , 2015, Journal of ophthalmology.

[5]  B. Seitz,et al.  Traumatic Keratoplasty Rupture Resulting From Continuous Positive Airway Pressure Mask , 2015, Cornea.

[6]  R. Zarei,et al.  Spontaneous wound dehiscence after penetrating keratoplasty. , 2014, International Journal of Ophthalmology.

[7]  Y. Ozertürk,et al.  Traumatic wound dehiscence after penetrating keratoplasty. , 2014, Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES.

[8]  D. Pahor [Characteristics of traumatic versus spontaneous wound dehiscence after penetrating keratoplasty]. , 2013, Klinische Monatsblatter fur Augenheilkunde.

[9]  H. Esfandiari,et al.  Traumatic Wound Dehiscence following Corneal Transplantation , 2012, Journal of ophthalmic & vision research.

[10]  S. Zarei‐Ghanavati,et al.  Traumatic Wound Dehiscence After Deep Anterior Lamellar Keratoplasty: Protective Role of Intact Descemet Membrane After Big-Bubble Technique , 2010, Cornea.

[11]  A. Foroutan,et al.  Traumatic Wound Dehiscence and Lens Extrusion After Penetrating Keratoplasty , 2009, Cornea.

[12]  K. Tsubota,et al.  Characteristics of traumatic globe rupture after keratoplasty. , 2009, Ophthalmology.

[13]  D. Frazer,et al.  Traumatic graft dehiscence after penetrating keratoplasty. , 2008, Ophthalmology.

[14]  A Viestenz,et al.  [Management of a ruptured globe]. , 2008, Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft.

[15]  Xie Li-xi Investigation of graft dehiscence after penetrating keratoplasty , 2006 .

[16]  W. Stark,et al.  Late traumatic corneal wound dehiscence after penetrating keratoplasty. , 2005, Archives of ophthalmology.

[17]  T. Tran,et al.  Traumatic globe rupture following penetrating keratoplasty , 2005, Graefe's Archive for Clinical and Experimental Ophthalmology.

[18]  W. V. Van Meter,et al.  Spontaneous wound dehiscence after removal of single continuous penetrating keratoplasty suture. , 2002, Ophthalmology.

[19]  S. Tseng,et al.  Traumatic wound dehiscence after penetrating keratoplasty: clinical features and outcome in 21 cases. , 1999, Cornea.

[20]  U. Rehany,et al.  Ocular trauma following penetrating keratoplasty: incidence, outcome, and postoperative recommendations. , 1998, Archives of ophthalmology.

[21]  S. Navon Management of the Ruptured Globe , 1995, International ophthalmology clinics.

[22]  T. H. Pettit,et al.  Traumatic wound dehiscence after penetrating keratoplasty. , 1987, American journal of ophthalmology.