Comparative Evaluation Of Clinical Characteristics And Visual Outcomes Of Traumatic And Non-Traumatic Graft Dehiscence Following Corneal Transplantation Surgery
Louis J Stevenson,1 Robin G Abell,1 Myra B McGuinness,2 Rasik B Vajpayee1,3,4 1Royal Victorian Eye and Ear Hospital, Melbourne, Victoria 3002, Australia; 2Centre for Eye Research Australia, Melbourne, Victoria 3002, Australia; 3University of Melbourne, Parkville, Victoria 3010, Australia; 4Vision Ey...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2019-11-01
|
| Series: | Clinical Ophthalmology |
| Subjects: | |
| Online Access: | https://www.dovepress.com/comparative-evaluation-of-clinical-characteristics-and-visual-outcomes-peer-reviewed-article-OPTH |
| _version_ | 1818897215997870080 |
|---|---|
| author | Stevenson LJ Abell RG McGuinness MB Vajpayee RB |
| author_facet | Stevenson LJ Abell RG McGuinness MB Vajpayee RB |
| author_sort | Stevenson LJ |
| collection | DOAJ |
| description | Louis J Stevenson,1 Robin G Abell,1 Myra B McGuinness,2 Rasik B Vajpayee1,3,4 1Royal Victorian Eye and Ear Hospital, Melbourne, Victoria 3002, Australia; 2Centre for Eye Research Australia, Melbourne, Victoria 3002, Australia; 3University of Melbourne, Parkville, Victoria 3010, Australia; 4Vision Eye Institute, Melbourne, Victoria 3004, AustraliaCorrespondence: Rasik B VajpayeeRoyal Victorian Eye and Ear Hospital, University of Melbourne, 32 Gisborne Street, East Melbourne, Victoria 3002, AustraliaEmail rasikv@unimelb.edu.auPurpose: To compare patient demographics, clinical associations and visual outcomes between traumatic and non-traumatic wound dehiscence, following corneal transplantation.Methods: Retrospective review of all patients presenting with post-keratoplasty wound dehiscence to the Royal Victorian Eye and Ear Hospital between January 2005 and December 2017. Patients with wound dehiscence following keratoplasty of any cause were included.Results: Of 71 eyes from 71 patients included, 60 (85%) were penetrating keratoplasty patients. The mean age was 56.4 years (SD=22.7, range 17.6–97) and 62% (n = 44) of patients were male. There were 28 (39%) cases of traumatic dehiscence and 43 (61%) cases of non-traumatic dehiscence. The median time interval from keratoplasty to dehiscence was significantly less in non-traumatic patients than traumatic patients (0.2 years, IQR 0.1–2.0 vs 2.3 years, IQR 0.3–14.8, p=0.01). There was no significant difference in best-corrected visual acuity at 6 months between traumatic and non-traumatic dehiscence (6/60 vs 6/36, p=0.62), suture technique (continuous vs interrupted, p=0.12), or graft type (penetrating keratoplasty vs deep anterior lamellar keratoplasty) after adjusting for keratoconus (p=0.41).Conclusion: Post-keratoplasty wound dehiscence is a serious complication and can cause significant loss of vision. While the risk of dehiscence is lifelong, the first 3 years post-keratoplasty carry the highest risk, with non-traumatic dehiscence tending to occur earlier than traumatic dehiscence.Keywords: graft dehiscence, trauma, keratoplasty, cornea |
| first_indexed | 2024-12-19T19:12:39Z |
| format | Article |
| id | doaj.art-2b34d920420348d5a0c7d1a3435ad6ff |
| institution | Directory Open Access Journal |
| issn | 1177-5483 |
| language | English |
| last_indexed | 2024-12-19T19:12:39Z |
| publishDate | 2019-11-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Clinical Ophthalmology |
| spelling | doaj.art-2b34d920420348d5a0c7d1a3435ad6ff2022-12-21T20:09:13ZengDove Medical PressClinical Ophthalmology1177-54832019-11-01Volume 132243224949835Comparative Evaluation Of Clinical Characteristics And Visual Outcomes Of Traumatic And Non-Traumatic Graft Dehiscence Following Corneal Transplantation SurgeryStevenson LJAbell RGMcGuinness MBVajpayee RBLouis J Stevenson,1 Robin G Abell,1 Myra B McGuinness,2 Rasik B Vajpayee1,3,4 1Royal Victorian Eye and Ear Hospital, Melbourne, Victoria 3002, Australia; 2Centre for Eye Research Australia, Melbourne, Victoria 3002, Australia; 3University of Melbourne, Parkville, Victoria 3010, Australia; 4Vision Eye Institute, Melbourne, Victoria 3004, AustraliaCorrespondence: Rasik B VajpayeeRoyal Victorian Eye and Ear Hospital, University of Melbourne, 32 Gisborne Street, East Melbourne, Victoria 3002, AustraliaEmail rasikv@unimelb.edu.auPurpose: To compare patient demographics, clinical associations and visual outcomes between traumatic and non-traumatic wound dehiscence, following corneal transplantation.Methods: Retrospective review of all patients presenting with post-keratoplasty wound dehiscence to the Royal Victorian Eye and Ear Hospital between January 2005 and December 2017. Patients with wound dehiscence following keratoplasty of any cause were included.Results: Of 71 eyes from 71 patients included, 60 (85%) were penetrating keratoplasty patients. The mean age was 56.4 years (SD=22.7, range 17.6–97) and 62% (n = 44) of patients were male. There were 28 (39%) cases of traumatic dehiscence and 43 (61%) cases of non-traumatic dehiscence. The median time interval from keratoplasty to dehiscence was significantly less in non-traumatic patients than traumatic patients (0.2 years, IQR 0.1–2.0 vs 2.3 years, IQR 0.3–14.8, p=0.01). There was no significant difference in best-corrected visual acuity at 6 months between traumatic and non-traumatic dehiscence (6/60 vs 6/36, p=0.62), suture technique (continuous vs interrupted, p=0.12), or graft type (penetrating keratoplasty vs deep anterior lamellar keratoplasty) after adjusting for keratoconus (p=0.41).Conclusion: Post-keratoplasty wound dehiscence is a serious complication and can cause significant loss of vision. While the risk of dehiscence is lifelong, the first 3 years post-keratoplasty carry the highest risk, with non-traumatic dehiscence tending to occur earlier than traumatic dehiscence.Keywords: graft dehiscence, trauma, keratoplasty, corneahttps://www.dovepress.com/comparative-evaluation-of-clinical-characteristics-and-visual-outcomes-peer-reviewed-article-OPTHgraft dehiscencetraumakeratoplastycornea |
| spellingShingle | Stevenson LJ Abell RG McGuinness MB Vajpayee RB Comparative Evaluation Of Clinical Characteristics And Visual Outcomes Of Traumatic And Non-Traumatic Graft Dehiscence Following Corneal Transplantation Surgery Clinical Ophthalmology graft dehiscence trauma keratoplasty cornea |
| title | Comparative Evaluation Of Clinical Characteristics And Visual Outcomes Of Traumatic And Non-Traumatic Graft Dehiscence Following Corneal Transplantation Surgery |
| title_full | Comparative Evaluation Of Clinical Characteristics And Visual Outcomes Of Traumatic And Non-Traumatic Graft Dehiscence Following Corneal Transplantation Surgery |
| title_fullStr | Comparative Evaluation Of Clinical Characteristics And Visual Outcomes Of Traumatic And Non-Traumatic Graft Dehiscence Following Corneal Transplantation Surgery |
| title_full_unstemmed | Comparative Evaluation Of Clinical Characteristics And Visual Outcomes Of Traumatic And Non-Traumatic Graft Dehiscence Following Corneal Transplantation Surgery |
| title_short | Comparative Evaluation Of Clinical Characteristics And Visual Outcomes Of Traumatic And Non-Traumatic Graft Dehiscence Following Corneal Transplantation Surgery |
| title_sort | comparative evaluation of clinical characteristics and visual outcomes of traumatic and non traumatic graft dehiscence following corneal transplantation surgery |
| topic | graft dehiscence trauma keratoplasty cornea |
| url | https://www.dovepress.com/comparative-evaluation-of-clinical-characteristics-and-visual-outcomes-peer-reviewed-article-OPTH |
| work_keys_str_mv | AT stevensonlj comparativeevaluationofclinicalcharacteristicsandvisualoutcomesoftraumaticandnontraumaticgraftdehiscencefollowingcornealtransplantationsurgery AT abellrg comparativeevaluationofclinicalcharacteristicsandvisualoutcomesoftraumaticandnontraumaticgraftdehiscencefollowingcornealtransplantationsurgery AT mcguinnessmb comparativeevaluationofclinicalcharacteristicsandvisualoutcomesoftraumaticandnontraumaticgraftdehiscencefollowingcornealtransplantationsurgery AT vajpayeerb comparativeevaluationofclinicalcharacteristicsandvisualoutcomesoftraumaticandnontraumaticgraftdehiscencefollowingcornealtransplantationsurgery |