Topography after repair of full-thickness corneal laceration

To characterize corneal topography after repair of full-thickness corneal laceration.

Ophthalmic emergency room serving as a trauma referral center.

Twenty-two eyes with full-thickness corneal lacerations were prospectively studied after standardized surgical repair. Computerized videokeratography was done 2 and 14 weeks after surgery, with the latter measurement corresponding to 6 to 8 weeks after all sutures were removed. Fellow uninjured eyes served as the control group.

Twenty eyes (91%) had a significant reduction in topographic distortion after suture removal. Mean corneal astigmatism, measured by simulated keratometry, was 10.70 diopters (D) +/- 5.90 D (SD) with sutures in place and 2.25 +/- 4.90 D after their removal (P < .005). Eighteen patients (82%) had 2.00 D or less of corneal astigmatism 6 to 8 weeks after all sutures were removed. The final distribution of topographic patterns was bow tie (50%), spherical/oval (36%), and irregular (14%). There was no significant correlation between laceration configuration (curvilinear, jagged, branched wound margins) and final topography. Lacerations that passed within 2.0 mm of the line of sight, however, were significantly more likely to have more than 2.00 D of final astigmatism. Mean central corneal power was 42.40 +/- 3.20 D in the injured eyes and 42.40 +/- 2.40 D in the uninjured fellow eyes.

Although high astigmatism is frequently produced by corneal sutures used to repair full-thickness lacerations, the cornea has a substantial topographic memory that results in a marked normalization of contour after suture removal.