Traumatic graft dehiscence after penetrating keratoplasty.

OBJECTIVE

To determine the incidence and to explore the risk factors for traumatic graft dehiscence after penetrating keratoplasty.

DESIGN

Retrospective case note review.

PARTICIPANTS

Five hundred seventy-two consecutive cases were included.

INTERVENTION

All subjects who underwent penetrating keratoplasty in 1 regional center between 1992 and 2004 inclusive.

MAIN OUTCOME MEASURES

Cases that experienced postoperative traumatic graft dehiscence were identified. Results from 12 other similar studies were pooled for comparison.

RESULTS

Fifteen eyes (2.6%) were treated for traumatic wound dehiscence after penetrating keratoplasty. The most striking feature of this series was the bimodal relationship of age and cause of graft dehiscence, with older patients involved in falls and younger patients in accidental or deliberate trauma. Factors that may influence the risk of traumatic graft dehiscence are discussed, in the light of the present findings and pooled data from previous series.

CONCLUSIONS

This case series indicates that there is long-term risk of traumatic wound dehiscence after penetrating keratoplasty. Younger patients, especially males, should be made aware that their eye, after keratoplasty, will always be vulnerable to injury. High-risk situations should be avoided if possible. Older patients at particular risk should have adequate risk reduction strategies, social support, and supervision, in particular to minimize the risk of falls.