Ruptured globes following radial and hexagonal keratotomy surgery

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).