Intracameral air following pneumatic noncontact tonometry in a recently post–perforating keratoplasty patient

PURPOSE: The purpose of this report is to highlight the potential risk of noncontact tonometry after routine uncomplicated penetrating keratoplasty (PK). CASE REPORT: After uncomplicated PK for keratoconus, routine noncontact tonometry was performed on the second postoperative day. In spite of the adequately closed wound and the tight suture, temporary wound dehiscence occurred, and two-thirds of the anterior chamber was occupied by air. The running suture remained intact, and the Seidel test was negative. One week postoperatively, the patient’s corrected distance visual acuity was 0.4 (0.4 logMAR), and the air bubble had absorbed. CONCLUSION: This is the first report to conclude that noncontact tonometry may not be sufficiently safe in the early postoperative period in normal PK cases. To prevent possible wound opening, we suggest the use of other tonometry methods during the first several months after PK.