Wang Xin, Liu Ting, Zhang Sai, Qi Xiaolin, Li Suxia, Shi Weiyun, Gao Hua
Qingdao University, Qingdao 266071, China.
Shandong Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Jinan 250021, China.
J Ophthalmol. 2018 Jul 8;2018:1435389. doi: 10.1155/2018/1435389. eCollection 2018.
To investigate the incidence, causes, occurrence time, and range of wound and outcomes of wound dehiscence in patients treated by penetrating keratoplasty (PK) or lamellar keratoplasty (LK).
We retrospectively reviewed medical records of keratoplasty in Shandong Eye Hospital from January 2006 to June 2017. Thirty-one eyes of 30 patients had sustained wound dehiscence (WD) after surgical treatment. The surgical type, causes, occurrence time, extent of the wound, treatment, and outcomes were recorded.
The study population consisted of 26 men and 4 women. The mean age at the occurrence of WD was 44.6 years old (range: 12-78 years), and the mean time from keratoplasty to WD was 45.9 months (range: 1-204 months). WD occurred in 23 eyes (23/1385, 1.66%) after PK and 8 eyes (8/1632, 0.49%) after LK ( < 0.05). Twenty-seven eyes (27/31, 87.0%) had trauma-induced dehiscence. The mean range of dehiscence was 5.5 o'clock. The vision ranged from 20/50 to light perception after wound suture. The eyes receiving LK had fewer serious complications than PK.
Compared with LK, PK seems to be more prone to result in wound dehiscence. The WD after LK may be less severe. The visual acuity after treatment of WD can be worse in the eyes with PK than LK.
探讨穿透性角膜移植术（PK）或板层角膜移植术（LK）治疗患者伤口裂开的发生率、原因、发生时间、范围及伤口裂开的结局。
回顾性分析2006年1月至2017年6月在山东眼科医院行角膜移植术的病历资料。30例患者的31只眼术后发生伤口裂开（WD）。记录手术方式、原因、发生时间、伤口范围、治疗方法及结局。
研究对象包括26例男性和4例女性。WD发生时的平均年龄为44.6岁（范围：12 - 78岁），角膜移植术至WD的平均时间为45.9个月（范围：1 - 204个月）。PK术后23只眼（23/1385，1.66%）发生WD，LK术后8只眼（8/1632，0.49%）发生WD（P<0.05）。27只眼（27/31，87.0%）因外伤导致裂开。裂开的平均范围为5.5点钟方向。伤口缝合后视力范围为从视力20/50至光感。接受LK手术的眼严重并发症少于PK手术的眼。
与LK相比，PK似乎更容易导致伤口裂开。LK术后的WD可能较轻。PK术后WD治疗后的视力可能比LK术后更差。
