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A functional corneal graft 34 years after penetrating keratoplasty (PKP) is rare and even rarer is its survival after wound dehiscence. We present a case of a 69-year-old man who had presented to the emergency services in January 2012 with corneal wound dehiscence OS extending to 8 o'clock following blunt trauma. His vision was perception of light. The best corrected visual acuity (BCVA) of the patient prior to graft dehiscence was 20/30. The patient had undergone optical penetrating keratoplasty for healed keratitis in OS in 1978 followed by phacoemulsification with intraocular lens implantation in 2009. Suturing of the graft was performed under topical anaesthesia. At 18 months follow-up, the BCVA was 20/60 with clear graft centrally and specular count was 865 cells/mm(2). This case highlights that early and appropriate management of corneal graft dehiscence can achieve good functional outcome even 34 years following PKP.

Management of traumatic wound dehiscence of a functional graft 34 years after penetrating keratoplasty