Abstract
We report two unusual cases of wound dehiscence associated with graft loss following Deep Anterior Lamellar Keratoplasty (DALK). The first case was a 41-year-old man who had DALK for keratoconus, resulting in visual recovery. The patient returned 14 months later, after being struck with a fist on his left eye, resulting in complete loss of the graft and a tear in the Descemet’s Membrane (DM). Grafting with a preserved cornea resulted in gradually recovery in both graft clarity and visual acuity. The second case was a 46-year-old man who had undergone uneventful DALK for keratoconus. Running suture removal was performed at 21 months postoperatively. When he returned 6 days later, the graft was lost and intact DM exposed. Securing a preserved corneal graft over the DM resulted in gradual recovery. These results indicate that wound dehiscence associated with complete graft loss can occur following uneventful DALK. Presence of a recipient DM may act as a physical barrier to other ocular tissues.
Highlights
Deep Anterior Lamellar Keratoplasty (DALK) is a procedure in which opaque of distorted corneal stroma is replaced with donor cornea
We report two unusual cases of wound dehiscence associated with graft loss following uneventful DALK
While suture removal was performed relatively early in postoperative period in their case, we removed the suture after 21 months following DALK
Summary
Deep Anterior Lamellar Keratoplasty (DALK) is a procedure in which opaque of distorted corneal stroma is replaced with donor cornea. Only few cases of traumatic wound dehiscence have been reported following DALK [2,3,4,5,6,7]. We report two unusual cases of wound dehiscence associated with graft loss following uneventful DALK. After stretching the DM by air injection in the anterior chamber, 10-0 nylon sutures were placed from recipient side of the cornea, passing to the graft through DM.
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