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Traumatic wound dehiscence after penetrating keratoplasty: case series and literature review.
MedLine Citation:
PMID:  22009915     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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.
Authors:
Johannes Steinberg; Mau-Thek Eddy; Toam Katz; Otto H Fricke; Gisbert Richard; Stephan J Linke
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-11
Journal Detail:
Title:  European journal of ophthalmology     Volume:  -     ISSN:  1724-6016     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9110772     Medline TA:  Eur J Ophthalmol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  0     Citation Subset:  -    
Affiliation:
University Medical Centre Hamburg-Eppendorf, Department of Ophthalmology, Hamburg, Germany.
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