Traumatic wound rupture after penetrating keratoplasty in Africa.
Aim-To investigate risk factors, visual outcome, and graft survival for traumatic wound rupture after penetrating keratoplasty.
Methods-A retrospective analysis of 336 patients who underwent penetrating keratoplasty from 1988 to 1995.
19 patients (5.7%) suffered traumatic postoperative wound rupture requiring surgical repair.
They were younger (mean age 16.6 years, 95% CI 13.2-20.6) and more frequently keratoconic (p=0.01) than other patients (mean age 28.9 years, 95% CI 26. - 31.0).
Mean postoperative follow up was 37.7 (SD 22.9) months and 24.5 (18.9) months for the rupture and non-rupture patients.
Mean interval between keratoplasty and rupture was 18 (21) weeks.
The lens was damaged and removed in 37% of ruptured eyes.
For keratoconics, the probability of graft survival at 5 years was lower (p=0.03) in the ruptured eyes (75%) than in the non-ruptured eyes (90%). Endothelial failure was a more common (p<0.05) cause of graft opacification in ruptured grafts than in intact grafts.
Of the ruptured eyes, 53% achieved a final corrected acuity of at least 6118 and 63% achieved at least 6/60 compared with 48% and 71% of the intact eyes respectively (both p>0.1).
The proportion of keratoconic eyes which achieved at least 6/60 was lower (p=0.02) in the ruptured eyes (67%) than the non-ruptured eyes (87%). Eyes with wound ruptures of 5 clock hours or greater were less likely (p<0.05) to achieve an acuity of 6118 and were more likely (...)
Mots-clés Pascal : Kératoplastie, Greffe transfixiante, Oeil, Rupture tissu, Greffon, Cornée, Complication, Postopératoire, Facteur risque, Kératocône, Age, Afrique, Homme, Chirurgie, Oeil pathologie, Kératopathie
Mots-clés Pascal anglais : Keratoplasty, Penetrating graft, Eye, Tissue rupture, Graft(material), Cornea, Complication, Postoperative, Risk factor, Keratoconus, Age, Africa, Human, Surgery, Eye disease, Keratopathy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0274858
Code Inist : 002B25B. Création : 16/11/1999.