Traumatic Wound Dehiscence Associated with Graft Loss Following Deep Anterior Lamellar Keratoplasty

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.