Characteristics And Outcomes Of Traumatic Wound Dehiscence After Corneal Transplant For Keratoconus

To examine the incidence, causes, characteristics, and the visual outcome of traumatic wound dehiscence (TWD) after penetrating keratoplasty (PK) compared to lamellar keratoplasty (LKP) for keratoconus (KC).

Retrospective study, review medical records of eyes underwent PK (n= 2863) and eyes underwent LKP (n=1716) for KC over a 7-year period, at King Khaled Eye Specialist Hospital. Data were collected on patient demographics, interval between keratoplasty and trauma, and characteristics and visual outcomes of TWD.

The medical records of all KC patients undergoing TWD repair after PK or LKP over a 7-year period at a tertiary eye hospital, were reviewed. Data were collected on patient demographics, interval between keratoplasty and trauma, and characteristics and visual outcomes of TWD.

Fifty-five (1.9%) PK and 30 (1.7%) LKP eyes sustained TWD (p=0.675). Approximately two-thirds of patients with TWD were males in both groups (63.6%, 70.0%, respectively). The mean age at trauma was 24.6± 6.7 years (range 12-41 years) in the PK group compared with 22.6± 6.0 years (range 13-34 years) in the LKP group (p=0.166). The median interval between keratoplasty and trauma was 6.2 (the interquartile range[IQR], 10.9) months for the PK group and 4.6 (IQR, 7.4) months for the LKP group (p=0.116). At the last follow-up after wound repair, visual acuity was similar between the PK and LKP groups (p=0.595).

In our study, the incidence of TWD after PK and LKP in patients with KC was within the previously reported range of values. All patients undergoing these procedures, especially males, should receive adequate information regarding this lifelong risk, and the need for protective eye-wear and seeking early medical advice when complications occur. This is one of the largest series of patients diagnosed with TWD after keratoplasty.

Financial Disclosure of all authors : none