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G.J. Ko, D.Y. Kunimoto, D.H. Fischer, J.I. Maguire, R.S. Kaiser, C.H. Park; Open Globe Injury Resulting From Corneal Graft Dehiscence . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3962.
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© ARVO (1962-2015); The Authors (2016-present)
To report the characteristics, mechanism of injury, treatment, and outcomes of open globe injury resulting from corneal graft dehiscence.
Charts of 1182 consecutive patients with open globe injuries presenting to Wills Eye Hospital between 1990 and 2001 were reviewed. Of these patients, 44 who had a prior history of penetrating keratoplasty in the involved eye were identified, and their characteristics and outcomes were analyzed.
Patients ranged from 12 to 91 years of age (median 76). Corneal grafts were placed 3 weeks to 24 years prior to open globe injury; six of the original grafts were placed due to previous trauma. On presentation, visual acuity ranged from 20/50 to no light perception with 93% (41 patients) worse than 20/800. Dehiscences ranged from one clock–hour to total dehiscence (average six clock–hours), and 9% (4 patients) had scleral involvement. Nine percent (4 patients) presented with retinal detachment.Twenty–seven percent (12 patients) underwent primary evisceration or enucleation, and 11% (4 patients) underwent subsequent enucleation. One patient’s course was complicated by post–injury endophthalmitis Only 7% (3 patients) had a final visual acuity of 20/100 or better (follow up mean 118 days).
The visual prognosis of traumatic corneal graft dehiscence is very poor. Presenting visual acuity is also very poor, and primary evisceration or enucleation is not uncommon in this population of patients.
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