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Prognosis poor with traumatic globe rupture after PK

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Prognosis is poor for traumatic wound dehiscence following penetrating keratoplasty, a retrospective study found. Lens expulsion was common, and visual acuity was 20/200 or worse after trauma in almost three-quarters of cases reviewed.

Thi Ha Chau Tran and colleagues in Paris retrospectively studied 26 patients who suffered surgical wound dehiscence after PK because of ocular blunt trauma. The mean patient age at time of trauma was 50 years old, and the mean interval between transplantation and trauma was 45 months. Globe rupture occurred at the graft-host junction in all patients.

Nine of 13 phakic eyes presented with lens expulsion. Eight of nine pseudophakic eyes lost the implants. Retinal detachment occurred in seven eyes within 3 months of the trauma. Five patients underwent vitreous surgery for posterior segment damage, and two eyes were regrafted.

At the last follow-up, only seven eyes of the 26 (27%) had better than 20/200 vision.

The study is published in the June issue of Graefe’s Archive for Clinical and Experimental Ophthalmology.