Traumatic globe rupture after non-Descemet’s stripping automated endothelial keratoplasty with scleral suture fixation of intraocular lens: a case report

Abstract Background: To report the first case of traumatic globe rupture after non-Descemet stripping automated endothelial keratoplasty (nDSAEK) with scleral suture fixation of intraocular lens (IOL). Case presentation: A 71-year old male was referred to our hospital with reduced vision in his left eye. He underwent cataract surgery in his left eye about 10 years ago. At presentation, slit-lamp examination of his left eye showed aphakic bullous keratopathy. We performed nDSAEK with scleral suture fixation of IOL. The surgical outcome was favorable. At 5 years after nDSAEK, he sustained globe rupture in his left eye from a fall. Slit-lamp examination demonstrated wound dehiscence and iris prolapse beneath the conjunctiva. However, the transplanted endothelium and Descemet’s membrane was attached completely to the recipient cornea, and there was no dislocation of the implanted IOL. No abnormal findings were observed in the posterior segment. We performed wound suturing and iris reconstruction. After 45 months, recipient and donor cornea retained clarity, and his visual acuity was 20/25. Conclusions: We encountered a patient with traumatic globe rupture after nDSAEK. It can be presumed that traumatic wound dehiscence after DSAEK is better visual outcome than traumatic wound dehiscence after conventional PKP. DSAEK might be resistant to traumatic injury because of the minimal incision than PKP. Key words: Descemet’s stripping automated endothelial keratoplasty, traumatic globe rupture, corneal transplantation