3148 Visual outcome following traumatic wound dehiscence in post-cataract surgery

Purpose: To examine the incidence, causes, characteristics, and the visual outcome of traumatic wound dehiscence (TWD) after penetrating keratoplasty (PK) compared to lamellar keratoplasty (LKP) for keratoconus. Methods: The medical records of all keratoconus patients undergoing TWD repair after PK or LKP over a 7-year period at the King Khaled Eye Specialist Hospital (KKESH), Riyadh were reviewed. Data were collected on patient demographics, interval between keratoplasty and trauma, and characteristics and visual outcomes of TWD. Results: During January 2006 to December 2012, 2863 eyes in KKESH underwent PK. Another 1716 eyes underwent LKP. Of these, 55 (1.9%) and 30 (1.7%) sustained TWD, respectively ( p = 0.675). Approximately two-thirds of patients with traumatic wound dehiscence (TWD) were males in both groups (63.6% and 70.0%, respectively). The mean age at trauma was 24.6 ± 6.7 years (range 12–41 years) in the PK group compared with 22.6 ± 6.0 years (range 13–34 years) in the LKP group ( p = 0.166). The median interval between keratoplasty and trauma was 6.2 (the interquartile range (IQR), 10.9) months for the PK group and 4.6 (IQR, 7.4) months for the LKP group ( p = 0.116). At the last follow-up after wound repair, visual acuity was similar between the PK and LKP groups ( p = 0.595). Conclusion: In our study, the incidence of TWD after PK and LKP in patients with keratoconus was within the previously reported range of values. All patients undergoing these procedures, especially males, should receive adequate information regarding this lifelong risk, and the need for protective eye-wear and seeking early medical advice when complications occur.

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Traumatic wound dehiscence following cataract surgery: A thing of the past?

Eye ◽

10.1038/eye.2001.11 ◽

2001 ◽

Vol 15 (1) ◽

pp. 42-44 ◽

Cited By ~ 16

Author(s):

J L Ball ◽

B K McLeod

Keyword(s):

Cataract Surgery ◽

Wound Dehiscence ◽

The Past ◽

Traumatic Wound

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Traumatic Wound Dehiscence after Keratoplasty: Characteristics, Risk Factors, and Visual Outcome

Journal of Ophthalmology ◽

10.1155/2015/631409 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

Mohamed Bahgat Goweida ◽

Hany Ahmed Helaly ◽

Alaa Atef Ghaith

Keyword(s):

Risk Factors ◽

Corneal Transplantation ◽

Anterior Segment ◽

Wound Dehiscence ◽

Visual Outcome ◽

Lamellar Keratoplasty ◽

Deep Anterior Lamellar Keratoplasty ◽

Anterior Lamellar Keratoplasty ◽

Traumatic Wound

Purpose.The study aimed at evaluating the patients’ characteristics, risk factors, complications, and visual outcome of traumatic wound dehiscence after keratoplasty.Patients and Methods. A retrospective case series that included 20 eyes of 20 patients who had undergone a previous keratoplasty procedure followed by traumatic wound dehiscence. Records of the selected patients were reviewed. The mean duration of follow-up after repair was 21 months. Included patients were recalled for the final follow-up visit.Results.The procedure of corneal transplantation was penetrating (PKP) in 16 eyes and deep anterior lamellar keratoplasty (DALK) in 4 eyes. The associated anterior segment injuries included iris prolapse in 17 eyes and lens extrusion in 12 eyes. The associated posterior segment injuries included vitreous hemorrhage in 11 eyes and retinal detachment in 4 eyes. The final BSCVA was 0.1 or better in 5 cases (25 %) and was better than hand motions (HM) to less than 0.1 in 7 cases (35 %).Conclusion.Traumatic wound dehiscence following keratoplasty results in poor visual outcome. Cases following DALK may have less wound extent and better final visual outcome. The dehiscence seems most likely to occur during the first year.

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The Impact of Volume on Cataract Surgery Visual Outcome

International Archives of BioMedical and Clinical Research ◽

10.21276/iabcr.2017.3.3.14 ◽

2017 ◽

Vol 3 (3) ◽

Author(s):

Atif Anwar ◽

◽

R H Maniar ◽

Sakeena Mushfiq

Keyword(s):

Cataract Surgery ◽

Visual Outcome ◽

The Impact

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Late traumatic wound dehiscence after phacoemulsification

Journal of Cataract & Refractive Surgery ◽

10.1016/s0886-3350(99)00419-8 ◽

2000 ◽

Vol 26 (7) ◽

pp. 1092-1093 ◽

Cited By ~ 8

Author(s):

Panos Routsis ◽

Bernard Garston

Keyword(s):

Wound Dehiscence ◽

Traumatic Wound

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Increased risk of periprosthetic joint infection after acute, traumatic wound dehiscence following primary total knee arthroplasty

The Bone & Joint Journal ◽

10.1302/0301-620x.103b6.bjj-2020-2425.r1 ◽

2021 ◽

Vol 103-B (6 Supple A) ◽

pp. 191-195

Author(s):

Elizabeth B. Gausden ◽

Matthew B. Shirley ◽

Matthew P. Abdel ◽

Rafael J. Sierra

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Periprosthetic Joint Infection ◽

Joint Infection ◽

Significant Risk ◽

Wound Dehiscence ◽

Increased Risk ◽

Primary Tkas ◽

Traumatic Wound ◽

Total Knee

Aims To describe the risk of periprosthetic joint infection (PJI) and reoperation in patients who have an acute, traumatic wound dehiscence following total knee arthroplasty (TKA). Methods From January 2002 to December 2018, 16,134 primary TKAs were performed at a single institution. A total of 26 patients (0.1%) had a traumatic wound dehiscence within the first 30 days. Mean age was 68 years (44 to 87), 38% (n = 10) were female, and mean BMI was 34 kg/m2 (23 to 48). Median time to dehiscence was 13 days (interquartile range (IQR) 4 to 15). The dehiscence resulted from a fall in 22 patients and sudden flexion after staple removal in four. The arthrotomy was also disrupted in 58% (n = 15), including a complete extensor mechanism disruption in four knees. An irrigation and debridement with component retention (IDCR) was performed within 48 hours in 19 of 26 knees and two-thirds were discharged on antibiotic therapy. The mean follow-up was six years (2 to 15). The association of wound dehiscence and the risk of developing a PJI was analyzed. Results Patients who sustained a traumatic wound dehiscence had a 6.5-fold increase in the risk of PJI (95% confidence interval (CI) 1.6 to 26.2; p = 0.008). With the small number of PJIs, no variables were found to be significant risk factors. However, there were no PJIs in any of the patients who were treated with IDCR and a course of antibiotics. Three knees required reoperation including one two-stage exchange for PJI, one repeat IDCR for PJI, and one revision for aseptic loosening of the tibial component. Conclusion Despite having a traumatic wound dehiscence, the risk of PJI was low, but much higher than experienced in all other TKAs during the same period. We recommend urgent IDCR and a course of postoperative antibiotics to decrease the risk of PJI. A traumatic wound dehiscence increases risk of PJI by 6.5-fold. Cite this article: Bone Joint J 2021;103-B(6 Supple A):191–195.

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