Corneal incision dehiscence during penetrating keratoplasty nine years after radial keratotomy

As the use of radial keratotomy (RK) to correct myopia increases, more patients are having penetrating keratoplasty (PK). Radial keratotomy incisions are known to show incomplete wound healing. When the radial corneal RK incisions are cut by the corneal trephine, the peripheral part of each incision may open, even years after surgery. In this case, a 56-year-old man had visual distortion and diplopia in one eye nine years after RK. Contact lenses did not correct the problem, and the patient could not tolerate the contact lenses. Penetrating keratoplasty was performed. During surgery about one-third of the peripheral RK incisions spontaneously opened, making suturing difficult. Although the final visual result was 20/20 corrected acuity, this case shows that RK incisions may remain incompletely healed and easily open during PK surgery as long as nine years after the RK surgery.