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Traumatic Wound Dehiscence Associated with Graft Loss Following Deep Anterior Lamellar Keratoplasty

Jun Shimazaki, Yoshiyuki Satake and Seika Shimazaki-Den

We report two unusual cases of wound dehiscence associated with graft loss following Deep Anterior Lamellar Keratoplasty (DALK). The first case was a 41-year-old man who had DALK for keratoconus, resulting in visual recovery. The patient returned 14 months later, after being struck with a fist on his left eye, resulting in complete loss of the graft and a tear in the Descemet’s Membrane (DM). Grafting with a preserved cornea resulted in gradually recovery in both graft clarity and visual acuity. The second case was a 46-year-old man who had undergone uneventful DALK for keratoconus. Running suture removal was performed at 21 months postoperatively. When he returned 6 days later, the graft was lost and intact DM exposed. Securing a preserved corneal graft over the DM resulted in gradual recovery. These results indicate that wound dehiscence associated with complete graft loss can occur following uneventful DALK. Presence of a recipient DM may act as a physical barrier to other ocular tissues.