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Yujuan Wang, Ting Huang; Complications and surgical treatment of wound dehiscence following penetrating keratoplasty. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1550.
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To investigate the characteristics of wound dehiscence following penetrating keratoplasty and evaluate surgical procedure and postoperative courses.
Thirty-two patients with wound dehiscence following penetrating keratoplasty (PKP) were retrospectively identified and reviewed. All involved eyes underwent wound repair combined with anterior and/or posterior segment surgery according to variable extents of globe damage. Visual acuity, intraocular pressure (IOP), graft clarity, and structural integrity of ocular posterior segment were followed-up for 6-18 months.
Twenty-four eyes survived, eight ended with atrophy. Eight patients with broken or loose sutures maintained clear grafts without other complications. In 14 eyes with 3-6-clock-hour wound dehiscence, eight had decreased visual acuity, 11 with graft opacity, five with abnormal IOP. In eight eyes with 6-9-clock-hour wound dehiscence, seven got decreased visual acuity, five with graft opacities, seven with abnormal intraocular pressure, eight with posterior segment damage. Both of the two patients with wound dehiscence over 9 clock hours resulted in graft opacities and posterior segment damage, and ended with globe atrophy.
After penetrating keratoplasty, the graft wound showed tectonic instability and poor tensile strength, even minor striking force could lead to corneal wound dehiscence, usually complicated with intraocular content herniation and posterior segment damage. Usually, this kind of trauma has more severe injuries and worse prognosis than usual ocular trauma.
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