Characteristics of Traumatic Globe Rupture after Keratoplasty
Received 7 August 2008; received in revised form 26 April 2009; accepted 28 April 2009. published online 22 September 2009.
Objective
To analyze risk factors of traumatic wound rupture after penetrating keratoplasty (PKP) or deep anterior lamellar keratoplasty (DALK).
Design
Retrospective case series.
Participants
A total of 1962 consecutive cases were included.
Methods
A review of consecutive patients undergoing either PKP (1776 eyes) or DALK (186 eyes) at 1 regional center between 1998 and 2006 was carried out to determine the incidence of traumatic globe rupture after keratoplasty. Ophthalmic and demographic factors were analyzed. A comparison with previous literature was performed.
Main Outcome and Measures
Incidence, causes, and final visual acuity.
Results
Of 43 eyes with globe rupture during this period, 36 received keratoplasty during this study period. The incidence of globe rupture after keratoplasty was 1.8% (36/1962). These 36 cases consisted of 35 of the 1776 eyes receiving PKP (2.0%) and 1 of the 186 eyes receiving DALK (0.5%). Globe rupture occurred 61.6±50.0 months (mean ± standard deviation) after keratoplasty in 43 cases. The major cause of trauma was a fall in elderly patients (73.2±8.4 years, 17 eyes), with lens damage occurring in all such cases. Although 15 eyes (34.9%) had a visual acuity of 20/200 or better at final follow-up, eyes showing lens damage were associated with poorer visual acuity than eyes with no lens damage (P<0.01).
Conclusions
Wound weakness persisted for a long period after keratoplasty. A fall was observed frequently in elderly patients and resulted in poor visual outcome. Globe rupture associated with lens injury could be the predictor for future visual outcome.
Financial Disclosure(s)
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Available online: September 19, 2009.
1Department of Ophthalmology, Tokyo Dental College, Chiba, Japan
2Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
Correspondence: Motoko Kawashima, MD, Department of Ophthalmology, Tokyo Dental College, Sugano 5-11-13 Ichikawa City, Chiba, Japan
Manuscript no. 2008-946.
Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
ABSTRACT