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...

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Autores principales:	Stevenson LJ, Abell RG, McGuinness MB, Vajpayee RB
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	graft dehiscence trauma keratoplasty cornea Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/2b34d920420348d5a0c7d1a3435ad6ff
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spelling	oai:doaj.org-article:2b34d920420348d5a0c7d1a3435ad6ff2021-12-02T06:41:52ZComparative Evaluation Of Clinical Characteristics And Visual Outcomes Of Traumatic And Non-Traumatic Graft Dehiscence Following Corneal Transplantation Surgery1177-5483https://doaj.org/article/2b34d920420348d5a0c7d1a3435ad6ff2019-11-01T00:00:00Zhttps://www.dovepress.com/comparative-evaluation-of-clinical-characteristics-and-visual-outcomes-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Louis 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, corneaStevenson LJAbell RGMcGuinness MBVajpayee RBDove Medical Pressarticlegraft dehiscencetraumakeratoplastycorneaOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 13, Pp 2243-2249 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	graft dehiscence trauma keratoplasty cornea Ophthalmology RE1-994
spellingShingle	graft dehiscence trauma keratoplasty cornea Ophthalmology RE1-994 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
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
format	article
author	Stevenson LJ Abell RG McGuinness MB Vajpayee RB
author_facet	Stevenson LJ Abell RG McGuinness MB Vajpayee RB
author_sort	Stevenson LJ
title	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_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_sort	comparative evaluation of clinical characteristics and visual outcomes of traumatic and non-traumatic graft dehiscence following corneal transplantation surgery
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/2b34d920420348d5a0c7d1a3435ad6ff
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Comparative Evaluation Of Clinical Characteristics And Visual Outcomes Of Traumatic And Non-Traumatic Graft Dehiscence Following Corneal Transplantation Surgery

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