Wound dehiscence after penetrating keratoplasty: Clinical characteristics of 51 cases treated at Bascom Palmer Eye Institute

Ann M. Renucci, Fabiana Bogossian Marangon, William W. Culbertson

Research output: Contribution to journalArticlepeer-review

33 Scopus citations

Abstract

PURPOSE: To describe the causes, clinical characteristics, and treatment of wound dehiscence in patients after penetrating keratoplasty (PK). METHODS: A retrospective chart review was completed, evaluating patients seen at Bascom Palmer Eye Institute between 1989 and 2001. RESULTS: All dehiscence occurred at the graft-host junction with an average of 5 hours of dehiscence, but no site preference was identified. Dehiscence occurred because of trauma (53%), suture-related complications (27%), infectious keratitis (8%), and spontaneous wound separation (12%). Twelve patients had either intraocular lens dislocation or expulsion; 42 patients underwent primary repair; 7 patients underwent primary PK; and 1 patient underwent primary evisceration. Surgical details were unavailable for 1 patient. Final visual acuity ranged from 20/20 to no light perception. Acuity was unavailable for 2 patients. Visual acuity was 20/200 or better in 23 patients (47%) and less than 20/200 in 26 patients (53%). Two patients (4%) had no light perception. The visual acuity of 13 patients (27%) was 20/40 or better at their last clinic visit. Comparison of predehiscence and postdehiscence visual acuity showed that 23 eyes (54%) had comparable vision after dehiscence, 11 eyes (25%) had improved vision, and 9 eyes (21%) had worsening of vision. CONCLUSIONS: These observations show that graft dehiscence can occur for a variety of reasons after PK, including trauma, infectious keratitis, suture failure, or spontaneous wound separation. The graft-host interface remains vulnerable after corneal transplant and is a potential area for wound dehiscence even many years after keratoplasty. Nevertheless, comparable or even improved vision is possible after wound dehiscence.

Original languageEnglish (US)
Pages (from-to)524-529
Number of pages6
JournalCornea
Volume25
Issue number5
DOIs
StatePublished - Jun 1 2006

Keywords

  • Graft separation
  • Penetrating keratoplasty
  • Suture failure
  • Trauma
  • Wound dehiscence

ASJC Scopus subject areas

  • Ophthalmology

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