TOPOGRAPHY AFTER REPAIR OF FULL-THICKNESS CORNEAL LACERATION

Purpose: To characterize corneal topography after repair of full-thick ness corneal laceration. Setting: Ophthalmic emergency room serving as a trauma referral center. Methods: Twenty-two eyes with full-thicknes s corneal lacerations were prospectively studied after standardized su rgical repair. Computerized videokeratography was done 2 and 14 weeks after surgery, with the latter measurement corresponding to 6 to 8 wee ks after all sutures were removed. Fellow uninjured eyes served as the control group. Results: Twenty eyes (91%) had a significant reduction in topographic distortion after suture removal. Mean corneal astigmat ism, measured by simulated keratometry, was 10.70 diopters (D) +/- 5.9 0 D (SD) with sutures in place and 2.25 +/- 4.90 D after their removal (P < .005). Eighteen patients (82%) had 2.00 D or less of corneal ast igmatism 6 to 8 weeks after all sutures were removed. The final distri bution of topographic patterns was bow tie (50%), spherical/oval (36%) , and irregular (14%). There was no significant correlation between la ceration configuration (curvilinear, jagged, branched wound margins) a nd final topography. Lacerations that passed within 2.0 mm of the line of sight, however, were significantly more likely to have more than 2 .00 D of final astigmatism. Mean central corneal power was 42.40 +/- 3 .20 D in the injured eyes and 42.40 +/- 2.40 D in the uninjured fellow eyes. Conclusion: Although high astigmatism is frequently produced by corneal sutures used to repair full-thickness lacerations, the cornea has a substantial topographic memory that results in a marked normali zation of contour after suture removal.