Clinical Observation Of Traumatic Wound Dehiscence After Penetrating Keratoplasty

Purpose: To investigate the patients' characteristics,risk factors,complications and visual outcome of traumatic wound dehiscence after penetrating keratoplasty,and to improve the importance and prevention of trauma after penetrating keratoplasty.Methods: A retrospective case series that included 8 eyes of 8 patients of our hospital from 2014 to 2015,who had undergone a previous penetrating keratoplasty procedure followed by traumatic wound dehiscence,with an English language literature review of the same period 49 eyes of 49 patients,a total of 57 eyes of 57 patients.Results: 57 eyes of 57 patients were aged 4-72 years,with an average age of 39.86 ± 17.63 years.Mean duration between the time of previous penetrating keratoplasty and the trauma was 23.05 ± 15.99 months,ranging from 0.6 month to 34 years.The associated anterior segment injuries included the lens / intraocular lens prolapse in 26 eyes,iris prolapse in 22 eyes,hyphema in 19 eyes.The associated posterior segment injuries included vitreous prolapse in 18 eyes,vitreous hemorrhage in 17 eyes,retinal detachment in 8 eyes,suprachoroidal hemorrhage in 3 eyes.All patients had endophthalmitis only 1 patient and proliferative vitreoretinopathy only 1 patient after traumatic wound dehiscence.The best corrected visual acuity was 0.1 or better in 21 eyes,was better than hand motions to less than 0.1 in 13 eyes,was hand motions or light perception in 15 eyes,and was no light perception vision in 8eyes after retreatment.The injury of the limbs and different objects is the most common cause of wound dehiscence in this study.Conclusion: Patients who undergo penetrating keratoplasty have a life-long risk of wound dehiscence,regardless of the age,indication for penetrating keratoplasty,time since penetrating keratoplasty,wound dehiscence is more likely to occur after trauma and most likely to occur in the first year after penetrating keratoplasty.Most patients have poor visual outcome,good visual outcome was associated without serious eye complications and posterior segment injury for a few patients.