Traumatic Graft Dehiscence after Penetrating Keratoplasty
Presented in part as a poster at: European Vision and Eye Research Conference, October 2005, Vilamoura, Portugal.
Received 2 October 2006; received in revised form 1 April 2007; accepted 2 April 2007. published online 22 June 2007.
Objective
To determine the incidence and to explore the risk factors for traumatic graft dehiscence after penetrating keratoplasty.
Design
Retrospective case note review.
Participants
Five hundred seventy-two consecutive cases were included.
Intervention
All subjects who underwent penetrating keratoplasty in 1 regional center between 1992 and 2004 inclusive.
Main Outcome Measures
Cases that experienced postoperative traumatic graft dehiscence were identified. Results from 12 other similar studies were pooled for comparison.
Results
Fifteen eyes (2.6%) were treated for traumatic wound dehiscence after penetrating keratoplasty. The most striking feature of this series was the bimodal relationship of age and cause of graft dehiscence, with older patients involved in falls and younger patients in accidental or deliberate trauma. Factors that may influence the risk of traumatic graft dehiscence are discussed, in the light of the present findings and pooled data from previous series.
Conclusions
This case series indicates that there is long-term risk of traumatic wound dehiscence after penetrating keratoplasty. Younger patients, especially males, should be made aware that their eye, after keratoplasty, will always be vulnerable to injury. High-risk situations should be avoided if possible. Older patients at particular risk should have adequate risk reduction strategies, social support, and supervision, in particular to minimize the risk of falls.
Available online: June 22, 2007.
1Department of Ophthalmology, Eye & Ear Clinic, Royal Victoria Hospital, Belfast, United Kingdom.
2Department of Ophthalmology, Institute of Clinical Science, Queen’s University of Belfast, Belfast, United Kingdom.
Correspondence to Michael A. Williams, BMedSci, MRCOphth, c/o Department of Geriatric Medicine, Whitla Medical Building, 97 Lisburn Road, Belfast BT9 7BL, United Kingdom.
Manuscript no. 2006-1115.
No author has any conflict of interests, commercial or otherwise, to declare.
ABSTRACT