Ruptured globe 20 years after radial and transverse keratotomy

To report a case of corneal rupture due to blunt trauma occurring 20 years after radial keratotomy (RK) and transverse keratotomy. A 57-year-old woman sustained direct blunt trauma to her right eye. Ocular examination revealed a ruptured globe involving two of the eight RK incisions connected together across the visual axis with iris incarceration in the wound. The transverse keratotomy scars remained intact. The patient underwent primary corneal wound repair and iris repositioning. The postoperative period was uneventful. The patient had a visual acuity of counting fingers at 1 m and is awaiting penetrating keratoplasty. Traumatic rupture of RK incisions can still occur after 20 years. Patients having undergone RK many years before should be warned of a possible life-long risk of traumatic rupture. RK scars appear to be more vulnerable to rupture than astigmatic keratotomy scars.