Characteristics of Traumatic Globe Rupture after Keratoplasty

Motoko Kawashima, Tetsuya Kawakita, Shigeto Shimmura, Kazuo Tsubota, Jun Shimazaki

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Objective: To analyze risk factors of traumatic wound rupture after penetrating keratoplasty (PKP) or deep anterior lamellar keratoplasty (DALK). Design: Retrospective case series. Participants: A total of 1962 consecutive cases were included. Methods: A review of consecutive patients undergoing either PKP (1776 eyes) or DALK (186 eyes) at 1 regional center between 1998 and 2006 was carried out to determine the incidence of traumatic globe rupture after keratoplasty. Ophthalmic and demographic factors were analyzed. A comparison with previous literature was performed. Main Outcome and Measures: Incidence, causes, and final visual acuity. Results: Of 43 eyes with globe rupture during this period, 36 received keratoplasty during this study period. The incidence of globe rupture after keratoplasty was 1.8% (36/1962). These 36 cases consisted of 35 of the 1776 eyes receiving PKP (2.0%) and 1 of the 186 eyes receiving DALK (0.5%). Globe rupture occurred 61.6±50.0 months (mean ± standard deviation) after keratoplasty in 43 cases. The major cause of trauma was a fall in elderly patients (73.2±8.4 years, 17 eyes), with lens damage occurring in all such cases. Although 15 eyes (34.9%) had a visual acuity of 20/200 or better at final follow-up, eyes showing lens damage were associated with poorer visual acuity than eyes with no lens damage (P<0.01). Conclusions: Wound weakness persisted for a long period after keratoplasty. A fall was observed frequently in elderly patients and resulted in poor visual outcome. Globe rupture associated with lens injury could be the predictor for future visual outcome. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Original languageEnglish
Pages (from-to)2072-2076
Number of pages5
JournalOphthalmology
Volume116
Issue number11
DOIs
Publication statusPublished - 2009 Nov

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Corneal Transplantation
Rupture
Penetrating Keratoplasty
Visual Acuity
Crystalline Lens
Wounds and Injuries
Lenses
Incidence
Disclosure
Demography
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Characteristics of Traumatic Globe Rupture after Keratoplasty. / Kawashima, Motoko; Kawakita, Tetsuya; Shimmura, Shigeto; Tsubota, Kazuo; Shimazaki, Jun.

In: Ophthalmology, Vol. 116, No. 11, 11.2009, p. 2072-2076.

Research output: Contribution to journalArticle

Kawashima, Motoko ; Kawakita, Tetsuya ; Shimmura, Shigeto ; Tsubota, Kazuo ; Shimazaki, Jun. / Characteristics of Traumatic Globe Rupture after Keratoplasty. In: Ophthalmology. 2009 ; Vol. 116, No. 11. pp. 2072-2076.
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abstract = "Objective: To analyze risk factors of traumatic wound rupture after penetrating keratoplasty (PKP) or deep anterior lamellar keratoplasty (DALK). Design: Retrospective case series. Participants: A total of 1962 consecutive cases were included. Methods: A review of consecutive patients undergoing either PKP (1776 eyes) or DALK (186 eyes) at 1 regional center between 1998 and 2006 was carried out to determine the incidence of traumatic globe rupture after keratoplasty. Ophthalmic and demographic factors were analyzed. A comparison with previous literature was performed. Main Outcome and Measures: Incidence, causes, and final visual acuity. Results: Of 43 eyes with globe rupture during this period, 36 received keratoplasty during this study period. The incidence of globe rupture after keratoplasty was 1.8{\%} (36/1962). These 36 cases consisted of 35 of the 1776 eyes receiving PKP (2.0{\%}) and 1 of the 186 eyes receiving DALK (0.5{\%}). Globe rupture occurred 61.6±50.0 months (mean ± standard deviation) after keratoplasty in 43 cases. The major cause of trauma was a fall in elderly patients (73.2±8.4 years, 17 eyes), with lens damage occurring in all such cases. Although 15 eyes (34.9{\%}) had a visual acuity of 20/200 or better at final follow-up, eyes showing lens damage were associated with poorer visual acuity than eyes with no lens damage (P<0.01). Conclusions: Wound weakness persisted for a long period after keratoplasty. A fall was observed frequently in elderly patients and resulted in poor visual outcome. Globe rupture associated with lens injury could be the predictor for future visual outcome. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.",
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