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T Tran, P Ellies, E Assaraf, G Renard; Ocular Trauma Following Penetrating Keratoplasty . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4239.
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Purpose: To evaluate the mechanism, clinical characteristics, management and visual outcome of ocular trauma following penetrating keratoplasty (PK). Method: Retrospective study assessing ocular injury after PK in our department between 1994 and 2001. Results: Twenty-four patients (12 men, 12 women), suffered surgical wound dehiscence because of ocular trauma. The mean age at trauma was 55.5 years (range, 9-88 years). The interval between transplantation and trauma ranged from 1 month to 20 years (mean interval, 50.2 months). Globe rupture occurred at the graft-host junction in all of patients. Three patients were aphakic before the trauma. Nine of twelve phakic eyes (75%) presented lens expulsion. Six of eight pseudophakic eyes (75%) had loss their implants. Graft dehiscence was managed with primary wound closure in all patients, except in some who required combination of anterior vitrectomy and intraocular lens removal. Retinal detachment occurred in 7 eyes (29.2%) within 2 weeks following the trauma. At last of follow up, only six eyes (25%) had visual acuity of 20/200 or better. Conclusion: Traumatic wound dehiscence is not rare and the prognosis is severe after the injury. Globe rupture at the graft-host junction demonstrated wound weakness persistence even longtime after the PK. Prevention of ocular trauma should be included in the management of the PK.
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