Traumatic wound dehiscence after penetrating keratoplasty

Eighteen eyes with wound dehiscence after penetrating keratoplasty were studied. Keratoplasty was performed for corneal scarring (n = 8), dystrophies (n = 6), graft failure (n = 2), and corneal edema (n = 2). The mean duration between keratoplasty and wound dehiscence was 6.54 months. All eyes underwent wound repair with or without iris excision, lensectomy, and vitrectomy. Grafts remained clear in eight eyes. Five eyes developed phthisis bulbi. Visual acuity was better than 20/200 in seven eyes. There was no site (quadrant) specificity for dehiscence. Trivial trauma resulted in dehiscence in 10 of the 18 eyes. The major determinants of visual outcome were the force of trauma and status of the posterior segment. Dehiscence of the graft-host junction in all cases reflects its persistent weakness after surgery.