Ruptured globes following radial and hexagonal keratotomy surgery
P. F. Vinger, W. F. Mieler, J. H. Oestreicher and M. Easterbrook
Department of Ophthalmology, Tufts Medical School, Medford, Mass., USA.
OBJECTIVE: To ascertain if cases of radial keratotomy wound rupture were
occurring and whether the globes ruptured through the corneal incisions.
DESIGN: Cases of traumatic ruptured globe after incisional corneal
refractive surgery were collected from ophthalmologists and from
peer-reviewed and other ophthalmic literature. RESULTS: Twenty-eight human
eyes (eight previously unreported) are known to have ruptured through
refractive corneal incisions in activities of daily living (n = 12),
assault (n = 7), motor vehicle accidents (n = 5), and sports (n = 4). Two
patients died of their injuries. Of the remaining 26 ruptured eyes, eight
(31%) recovered 20/40 or better visual acuity. Six eyes (23%) were totally
blinded, six (23%) were legally blinded, and six (23%) had best corrected
visual acuity of 20/40 to 20/100 despite multiple surgical procedures.
CONCLUSIONS: As radial keratotomy becomes more popular the pool of patients
who may experience traumatic ruptured globe will grow. Every patient who
has had radial keratotomy should be aware that the surgery has weakened the
eye(s).
