Baki Kartal1, Baran Kandemir2, Turan Set3, Süleyman Kuğu2, Sadullah Keleş4, Erdinç Ceylan5, Berkay Akmaz2, Aytekin Apil6, Yusuf Ozertürk2. 1. Department of Ophthalmolgy, Regional Training and Research Hospital, Erzurum, Turkey. baki_kartal@yahoo.com. 2. Department of Ophthalmology, Dr. Lütfi Kırdar Kartal Training and Research Hospital, İstanbul, Turkey. 3. Department of Family Medicine, Atatürk University Faculty of Medicine, Erzurum, Turkey. 4. Department of Ophthalmology, Atatürk University Faculty of Medicine, Erzurum, Turkey. 5. Department of Ophthalmolgy, Regional Training and Research Hospital, Erzurum, Turkey. 6. Department of Ophthalmolgy, Bakırköy Sadi Konuk Training and Research Hospital, İstanbul, Turkey.
Abstract
BACKGROUND: We aimed to evaluate the risk factors, clinical features and outcomes of surgery for traumatic wound dehiscence (TWD) following penetrating keratoplasty (PK). METHODS: Twenty-six patients with TWD following PK were evaluated retrospectively in terms of factors related to the trauma, types of reconstructive surgery, final graft clarity, and visual acuity. RESULTS: There were 26 patients with a mean age of 40.7±19.6 years. In 12 (46.1%) patients, the better eye was affected by the trauma. The most frequent type of trauma was blunt trauma by various objects (9). In all cases, the dehiscence was at the graft host junction. The mean extent of detachment was 135.4°±57.6°. Crystalline or intraocular lens damage was present in 42.3% of cases. Median follow-up time after the reconstructive surgery was 36 months. The graft remained clear in 13 (50%) patients, whereas graft insufficiency/graft rejection developed in 13 (50%) patients. Final visual acuity was over 20/200 in 13 (50%) patients. CONCLUSION: TWD may occur at any time after PK, most frequently within the first postoperative year. Low visual acuity in the other eye seems to be a major risk factor. In patients without major complications such as posterior segment damage, visual outcomes and graft survival can be favorable.
BACKGROUND: We aimed to evaluate the risk factors, clinical features and outcomes of surgery for traumatic wound dehiscence (TWD) following penetrating keratoplasty (PK). METHODS: Twenty-six patients with TWD following PK were evaluated retrospectively in terms of factors related to the trauma, types of reconstructive surgery, final graft clarity, and visual acuity. RESULTS: There were 26 patients with a mean age of 40.7±19.6 years. In 12 (46.1%) patients, the better eye was affected by the trauma. The most frequent type of trauma was blunt trauma by various objects (9). In all cases, the dehiscence was at the graft host junction. The mean extent of detachment was 135.4°±57.6°. Crystalline or intraocular lens damage was present in 42.3% of cases. Median follow-up time after the reconstructive surgery was 36 months. The graft remained clear in 13 (50%) patients, whereas graft insufficiency/graft rejection developed in 13 (50%) patients. Final visual acuity was over 20/200 in 13 (50%) patients. CONCLUSION: TWD may occur at any time after PK, most frequently within the first postoperative year. Low visual acuity in the other eye seems to be a major risk factor. In patients without major complications such as posterior segment damage, visual outcomes and graft survival can be favorable.
Authors: Joseph Matar Mass Ndiaye; Aboubacry Sadikh Sow; Habsa Kane; Jean Pierre Diagne; Aïssatou Magatte Wane; Aly Mbarka Ka; Elhadji Amadou Ba; Paule Aida Ndoye Roth Journal: Pan Afr Med J Date: 2020-09-07