Observations on Traumatic Wound Dehiscence Following Corneal Transplantation

Abstract

Objective: To describe the clinical characteristics of traumatic wound dehiscence after penetrating keratoplasty and to evaluate the associated visual, anatomical, and graft-related outcomes.
Methods: Cases of wound dehiscence following penetrating keratoplasty, treated from 2012 to 2025, were evaluated retrospectively. Data were extracted from the medical records of 33 patients, identified among 1632 patients who had previously undergone penetrating keratoplasty. Patient records were examined to determine the type and timing of the injury, corrected distance visual acuity (CDVA), and clinical outcomes.
Results: Across 1632 keratoplasties, 33 traumatic dehiscence events were recorded (2.0%). A total of 33 patients, including 9 females (27.3%) and 24 males (72.7%), with a mean age of 57.03 ± 17.43 years (range: 24–89), were included in the analysis. The most common indication for penetrating keratoplasty (PK) was pseudophakic bullous keratopathy (PBK), accounting for 33.3% of cases. In the present study, the median time from keratoplasty to traumatic wound dehiscence was 29 months (range: 4–177 months). At the final follow-up, the mean CDVA was 2.02±0.7 LogMAR (range: 0.22–3.0).
Conclusions: Traumatic wound dehiscence is a lifelong risk after penetrating keratoplasty due to persistent wound fragility. Even minor trauma can cause severe vision loss years post-surgery. Early treatment improves outcomes, highlighting the importance of patient education and protective eyewear use.

Keywords

• Cornea
• Corneal transplantation
• Penetrating keratoplasty
• Wound dehiscence

Ethical Statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was conducted in accordance with the principles of the Declaration of Helsinki and the decision of the İzmir City Hospital Ethics Committee dated 18/06/2025 and numbered 2025/278.

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