Murata Noriaki, Yokogawa Hideaki, Kobayashi Akira, Yamazaki Natsuko, Sugiyama Kazuhisa
Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
Clin Ophthalmol. 2013;7:461-5. doi: 10.2147/OPTH.S42117. Epub 2013 Mar 5.
In this paper, we report our experience of the clinical features of single and repeated globe rupture after penetrating keratoplasty.
We undertook a retrospective analysis of single and repeated globe ruptures following keratoplasty in eight eyes from seven consecutive patients referred to Kanazawa University Hospital over a 10-year period from January 2002 to March 2012. We analyzed their ophthalmic and demographic data, including age at time of globe rupture, incidence, time interval between keratoplasty and globe rupture, cause of rupture, complicated ocular damage, and visual outcome after surgical repair.
Five patients (71.4%) experienced a single globe rupture and two patients (28.6%) experienced repeated globe ruptures. Patient age at the time of globe rupture was 75.4 ± 6.8 (range 67-83) years. Four of the patients were men and three were women. During the 10-year study period, the incidence of globe rupture following penetrating keratoplasty was 2.8%. The time interval between penetrating keratoplasty and globe rupture was 101 ± 92 months (range 7 months to 23 years). The most common cause of globe rupture in older patients was a fall (n = 5, 79.8 ± 3.7 years, all older than 67 years). Final best-corrected visual acuity was >20/200 in three eyes (37.5%). In all except one eye, globe rupture involved the graft-host junction; in the remaining eye, the rupture occurred after disruption of the extracapsular cataract extraction wound by blunt trauma.
Preventative measures should be taken to avoid single and repeated ocular trauma following penetrating keratoplasty.
在本文中，我们报告了穿透性角膜移植术后单次及反复眼球破裂的临床特征方面的经验。
我们对2002年1月至2012年3月这10年间转诊至金泽大学医院的7例连续患者的8只眼进行了穿透性角膜移植术后单次及反复眼球破裂的回顾性分析。我们分析了他们的眼科和人口统计学数据，包括眼球破裂时的年龄、发生率、角膜移植与眼球破裂之间的时间间隔、破裂原因、并发眼损伤以及手术修复后的视力结果。
5例患者（71.4%）经历了单次眼球破裂，2例患者（28.6%）经历了反复眼球破裂。眼球破裂时患者的年龄为75.4±6.8岁（范围67 - 83岁）。其中4例患者为男性，3例为女性。在10年的研究期间，穿透性角膜移植术后眼球破裂的发生率为2.8%。穿透性角膜移植与眼球破裂之间的时间间隔为101±92个月（范围7个月至23年）。老年患者眼球破裂最常见的原因是跌倒（n = 5，年龄79.8±3.7岁，均大于67岁）。最终最佳矫正视力在3只眼中>20/200（37.5%）。除1只眼外，所有眼球破裂均累及植片 - 宿主交界处；在其余1只眼中，破裂发生在钝性创伤导致囊外白内障摘除伤口裂开之后。
应采取预防措施以避免穿透性角膜移植术后的单次及反复眼外伤。
