Zur Pathogenese der Hurrican-Keratitis

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Abstract
Hurricane keratitis is an epithelial disorder of corneal transplants which occurs irrespectively of the type of local postoperative therapy used. The epithelial defects show a vortex-like arrangement resembling satellite photos of whirlwinds. Even before the development of punctate keratitis, fluorescein staining of the corneal surface reveals vortex-like figures corresponding to a varying thickness of the tear film in a vortex-like configuration. The irregularities in the tear film are due to an irregular profile of the corneal surface, the functional result of which is irregular astigmatism. The irregular surface profile in turn is caused by the approximation of incongruent wound edges and by sutures being too tightly drawn. Particularly when Healon is used, there is a tendency to draw the sutures tight, since a postoperative pressure increase with subsequent fistulation must be expected. Hurricane keratitis thus also appears to result indirectly from the use of Healon.