Traumatic wound dehiscence after penetrating keratoplasty: case series and literature review.
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Traumatic wound dehiscence after penetrating keratoplasty: case series and literature review. / Steinberg, Johannes; Eddy, Mau-Thek; Katz, Toam; Fricke, Otto H; Richard, Gisbert; Linke, Stephan.
In: EUR J OPHTHALMOL, Vol. 22, No. 3, 3, 2011, p. 335-341.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Traumatic wound dehiscence after penetrating keratoplasty: case series and literature review.
AU - Steinberg, Johannes
AU - Eddy, Mau-Thek
AU - Katz, Toam
AU - Fricke, Otto H
AU - Richard, Gisbert
AU - Linke, Stephan
PY - 2011
Y1 - 2011
N2 - Purpose. Blunt trauma after penetrating keratoplasty (PK) is a high risk for wound rupture at the donor-recipient interface. We present 6 cases of traumatic wound dehiscence after PK; we describe the morphologic and functional outcome after surgical intervention and provide a review of the current literature. Methods. Six patients with a traumatic wound dehiscence after PK were analyzed retrospectively from the files of the University Eye Hospital Hamburg-Eppendorf (1998-2009). In addition, a comprehensive literature review was performed. Results. The indications for PK were keratoconus, corneal scars, and Fuchs endothelial dystrophy. The age range was 22-81 years; the time span between PK and globe rupture was 1 month to 27 years. The cause of the dislocation was a fall or blunt trauma, through a branch, airbag, fist, or finger. The corrected distance visual acuity (CDVA) pretrauma ranged between hand movement and 20/32. The CDVA after wound repair was 20/400 to 20/25 depending on the severity of the trauma. In 3 of the 6 cases, visual rehabilitation was superior to the pretrauma vision, whereas in 3 cases the pretrauma CDVA could not be reached. Conclusions. If a timely and adequate treatment of the traumatically dislocated transplant can be given, it is likely that the transplant will survive. Nevertheless, severely reduced visual acuity (i.e., <hand movement) and lens damage at the time of trauma are the most reliable predictors for the final visual outcome. A permanent loss of visual acuity is related rather to the intraocular damage (vitreous loss, vitreous bleeding, retinal tears, and retinal detachment) than to the readapted transplant itself.
AB - Purpose. Blunt trauma after penetrating keratoplasty (PK) is a high risk for wound rupture at the donor-recipient interface. We present 6 cases of traumatic wound dehiscence after PK; we describe the morphologic and functional outcome after surgical intervention and provide a review of the current literature. Methods. Six patients with a traumatic wound dehiscence after PK were analyzed retrospectively from the files of the University Eye Hospital Hamburg-Eppendorf (1998-2009). In addition, a comprehensive literature review was performed. Results. The indications for PK were keratoconus, corneal scars, and Fuchs endothelial dystrophy. The age range was 22-81 years; the time span between PK and globe rupture was 1 month to 27 years. The cause of the dislocation was a fall or blunt trauma, through a branch, airbag, fist, or finger. The corrected distance visual acuity (CDVA) pretrauma ranged between hand movement and 20/32. The CDVA after wound repair was 20/400 to 20/25 depending on the severity of the trauma. In 3 of the 6 cases, visual rehabilitation was superior to the pretrauma vision, whereas in 3 cases the pretrauma CDVA could not be reached. Conclusions. If a timely and adequate treatment of the traumatically dislocated transplant can be given, it is likely that the transplant will survive. Nevertheless, severely reduced visual acuity (i.e., <hand movement) and lens damage at the time of trauma are the most reliable predictors for the final visual outcome. A permanent loss of visual acuity is related rather to the intraocular damage (vitreous loss, vitreous bleeding, retinal tears, and retinal detachment) than to the readapted transplant itself.
KW - Adult
KW - Aged, 80 and over
KW - Cornea
KW - Corneal Diseases
KW - Eye Injuries
KW - Female
KW - Humans
KW - Keratoplasty, Penetrating
KW - Lens Implantation, Intraocular
KW - Male
KW - Retrospective Studies
KW - Surgical Wound Dehiscence
KW - Time Factors
KW - Visual Acuity
KW - Wounds, Nonpenetrating
KW - Young Adult
U2 - 10.5301/ejo.5000057
DO - 10.5301/ejo.5000057
M3 - SCORING: Journal article
C2 - 22009915
VL - 22
SP - 335
EP - 341
JO - EUR J OPHTHALMOL
JF - EUR J OPHTHALMOL
SN - 1120-6721
IS - 3
M1 - 3
ER -