Vitreous wick syndrome following a corneal relaxing incision.

A 55-year-old white female underwent a 7.5 mm penetrating keratoplasty for stromal scarring secondary to herpex simplex keratitis. Postoperatively, stromal vascularization and a prolonged graft rejection forced premature suture removal and a prolonged course of topical and systemic glucocorticoids. A mild anterior wound gape spontaneously closed with reduction of steroid therapy. Eighteen months after the original surgery, the patient underwent a relaxing corneal incision to correct 12 diopters of corneal astigmatism. During an inferior incision a small microperforation was noted and the procedure was terminated. Eleven days after the relaxing incision, the patient returned with a "vitreous wick" syndrome through the superior incision. The wound dehiscence and vitreous wick were repaired without incident and the astigmatism was reduced to 7 diopters. Incisions more than 3/4 depth in aphakic patients, or in patients who have required intense steroid therapy should be monitored closely for several days after surgery for microperforations or a wound dehiscence which may lead to a "vitreous wick" syndrome.