Keratoplasty wound separations.

Forty cases of partial or full-thickness corneal wound separtions after penetrating keratoplasty comprised three groups. One group of separations occurred before suture removal, due to technical problems encountered at surgery or increased intraocular pressure, or both. Most separations occurred immediately after suture removal and may be the most preventable. The third group of separations occurred long after suture-removal and may not be associated with obvious trauma. About 50% of all wound separations caused graft failure, but patients with fullthickness wound separations had a worse prognosis for visual acuity recovery. Of those grafts that failed after wound separation and were retransplanted, there is a good chance of visual recovery. In our series, fullthickness wound separations or partial wound gape occurred in about 5.7% of our transplant cases. With delay of suture removal associated with a more adequate clinical means of evaluating wound healing, this number may be decreased.