Keratoplasty following anterior segment trauma

This paper reports and analyses 20 keratoplasties with or without anterior segment reconstruction carried out for penetrating injuries of the anterior segment. The results show that 80% clear grafts were achieved and 65% of eyes had vision restored to 6/18 or better. No eyes were lost. The complications were retinal detachments 2 cases, corneal graft rejection 2 cases, glaucoma 4 cases (2 mild and easily controlled) and one each of amblyopia and retinal folds through macular area. Eyes that have "quietened" following severe penetrating injuries of the anterior segment should be considered for penetrating keratoplasty and anterior segment reconstruction if they retain normal intraocular pressures and have vision of at least accurate projection of light in all quadrants. As well as achieving clear grafts and improvement of vision as above, all eyes had better cosmetic appearance. Two eyes had an ipsilateral rotational autokeratoplasty. This technique has a role to play when central scarring can be rotated to the periphery if sufficient undamaged cornea remains and interference with angle structures can be minimised.