| Delayed-Onset Expulsive Suprachoroidal Hemorrhage Due to a Trauma after Removal of Penetrating Keratoplasty Suture. |
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Youn Joo Choi, Moon Sun Jung |
1Department of Ophthalmology, Soonchunhyang University College of Medicine, Seoul, Korea.
2Department of Ophthalmology, Soonchunhyang University Cheonan Hospital, Cheonan, Korea. greenizy@lycos.co.kr |
| 전층각막이식 봉합사 제거 후 외상에 의해 발생한 지연성 축출성 맥락막상강출혈 1예 |
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최연주1⋅정문선1,2 |
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Department of Ophthalmology, Soonchunhyang University College of Medicine 1, Seoul, Korea Department of Ophthalmology, Soonchunhyang University Cheonan Hospital2, Cheonan, Korea |
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| Abstract |
PURPOSE
To report a case of delayed-onset expulsive suprachoroidal hemorrhage due to trauma after removal of a penetrating keratoplasty suture. CASE SUMMARY: A 66-year-old man had penetrating keratoplasty for bullous keratopathy performed in his left eye. After 1 year, the continuous suture was removed for adjustment of astigmatism. Four days after removal of the suture, the patient struck his left eye with the back of his hand, although at the time of injury he had no specific symptoms. Two days later, the patient noticed abrupt pain, decreased visual acuity, and massive hemorrhage in his left eye. Examination revealed an inferior wound dehiscence of approximately 8 clock hours (2 thru 10 o'clock) with prolapsed intraocular contents such as the uvea and retina. The patient underwent cornea graft resuturing with resection of ocular contents, which could not be repositioned. Although bleeding was controlled after the operation, vision was lost in his left eye. After two months, according to decrement of intraocular hematoma, the patient had a phthisis bulbi with low intraocular pressure in his left eye. CONCLUSIONS: Persistent low intraocular pressure due to wound leakage through the graft-host junction likely resulted in delayed onset of expulsive suprachoroidal hemorrhage. The risk of traumatic corneal graft rupture after penetrating keratoplasty is significant and is associated with a poor visual outcome and eyeball viability. Therefore, patients should be cautioned. In addition, the importance of eye examination after trauma should be emphasized. |
| Key Words:
Penetrating keratoplasty;Suprachoroidal hemorrhage;Trauma;Wound dehiscence |
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