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Traumatic wound dehiscence following corneal transplantation
Poster Details
First Author: H.Hasani IRAN
Co Author(s): M. Jafarinasab S. Feizi H. Esfandiari B. Kheiri M. Feizi
Abstract Details
Purpose:
To investigate the incidence, mechanisms, characteristics, and visual outcomes
of traumatic wound dehiscence following keratoplasty.
Setting:
Labbafinejad Medical Center,Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Methods:
Medical records of 32 consecutive patients with traumatic globe rupture
following keratoplasty who had been treated at our center from 2001 to 2009 were retrospectively reviewed.
Results:
The study population consisted of 32 eyes of 32 patients including 25 men
and 7 women with history of corneal transplantation who had sustained eye trauma
leading to globe rupture. Mean patient age was 38.1 (range, 8 to 87) years and median
interval between keratoplasty and the traumatic event was 9 months (range, 30 days
to 20 years). Associated anterior segment findings included iris prolapse in 71.9%, lens
extrusion in 34.4%, and hyphema in 40.6% of eyes. Posterior segment complications
included vitreous prolapse (56%), vitreous hemorrhage (28%) and retinal detachment
(18%). Eyes which had undergone deep anterior lamellar keratoplasty (DALK; 5 cases,
15.6%) tended to have less severe presentation and better final visual acuity. There was
no correlation between the time interval from keratoplasty to the traumatic event, and
final visual outcomes.
Conclusions:
The host-graft interface demonstrates decreased stability long after surgery
and the visual prognosis of traumatic wound dehiscence is poor in many cases. An
intact Descemet's membrane in DALK may mitigate the severity of ocular injuries, but
even in these cases, the visual outcome of globe rupture is not good and prevention of
ocular trauma should be emphasized to all patients undergoing any kind of keratoplasty. FINANCIAL INTEREST: NONE