TRAUMATIC WOUND DEHISCENCE 3-1 2 YEARS AF TER RADIAL KERATOTOMY/

Background Severe complications such as a traumatic wound dehiscence h ave been described very rarely after radial keratotomy. The following case demonstrates for the first time that wound healing is not complet ed even 31/2 years postoperatively and that therefore an ocular blunt trauma may still cause a dehiscence of the radial incisions. Case Repo rt A 22-year-old patient presented in July 1993 to our emergency unit because of a corneal perforation in his right eye after a blunt trauma . His past medical history was significant for radial keratotomy surge ry performed in January 1990 to correct a bilateral low-degree myopia (OD = -3.25 D; OS = -3,75 D). At surgery a horizontal rupture running through the entire cornea and including the two radial keratotomies at the 3 and 9 o'clock position was evident. The whole iris and lens wer e missing. The retina was completely detached. The corneal laceration was sutured. Twelve days later the retina was reattached with an encir cling band, vitrectomy, endolaser and cryocoagulation, as well as sili cone oil fill. Finally, a penetrating keratoplasty was performed 6 mon ths after the accident. Thereafter, visual acuity improved to 0.1. The histologic examination of the corneal button showed that the wound he aling of the incisions that had remained intact was not completed yet. Epithelial plugs of various size were still filling the somewhat dehi scent wound margins. Fibroblastic activity was detected in the surroun ding stroma. Conclusion Even several years after surgery, blunt trauma s represent a definite risk for eyes undergoing radial keratotomy.