Traumatic wound dehiscence following penetrating keratoplasty

Four young male patients with keratoconus had traumatic dehiscence of the surgical wound after penetrating keratoplasty. Two were rendered aphakic by the trauma, and in one patient the lens was dislocated posteriorly. In each case the dehiscence was repaired by resuturing the original corneal graft. Despite marked corneal oedema in the immediate postoperative period all four grafts deturgesced and subsequently cleared. The follow-up has been a minimum of 23 months. We recommend therefore primary resuturing of traumatic wound dehiscence after keratoplasty, anterior vitrectomy if the lens dislodged, and prophylactic antibiotics postoperatively. The clearing of the initially oedematous grafts in each case illustrates the resilience of the corneal endothelium.