J Korean Ophthalmol Soc.  2017 Jun;58(6):740-744. 10.3341/jkos.2017.58.6.740.

A Case of Spontaneous Corneal Perforation Combined with Primary Pterygium

• Hwang SH
• Kim DH

• KMID: 2382686
• DOI: http://doi.org/10.3341/jkos.2017.58.6.740

Abstract

PURPOSE
We report a case of spontaneous corneal perforation combined with primary pterygium.
CASE SUMMARY
A 66-year-old male presented with a foreign body sensation in his right eye. He had no systemic or ocular inflammatory diseases. He had undergone penetrating keratoplasty following amniotic membrane transplantation for corneal perforation at 1 day after pterygium excision in his left eye. The uncorrected visual acuity (UCVA) and intraocular pressure (IOP) in his right eye were 0.8 and 2 mmHg, respectively. Active leakage of an aqueous humor on the head of the pterygium was found on slit lamp examination. With the impression of spontaneous corneal perforation combined with primary pterygium, emergent amniotic membrane transplantation was performed. Diffuse corneal thinning around the 2 mm-sized perforation site was found 3mm away from the limbus in the 5 o'clock after removing the pterygium. The perforation site was covered with amniotic membrane after applying fibrin glue. UCVA and IOP in his right eye were 1.0 and 9 mmHg, respectively, at postoperative 6 months. No definite recurrence of pterygium or additional corneal perforation was found.
CONCLUSIONS
Spontaneous corneal perforation may be related to primary pterygium.

Keyword

Amniotic membrane transplantation; Corneal perforation; Pterygium

MeSH Terms

Aged
Amnion
Aqueous Humor
Corneal Perforation*
Fibrin Tissue Adhesive
Foreign Bodies
Head
Humans
Intraocular Pressure
Keratoplasty, Penetrating
Male
Pterygium*
Recurrence
Sensation
Slit Lamp
Visual Acuity
Fibrin Tissue Adhesive

Figure

• 

  Figure 1 Anterior segment photographs and schematic figure. (A, B) Nasal pterygium and active leakage of aqueous humor on the head of pterygium were found in the right eye (arrows). (C) Bullous keratopathy after penetrating keratoplasty for instant corneal perforation following pterygium excision on his left eye. (D) Schematic figure of corneal perforation and pterygium on the right eye. (E) The perforation site was covered with amniotic membrane in postoperative 3 weeks. (F) Corneal surface was smooth and mild stromal opacity was found at the previous amniotic membrane transplantation site in postoperative 9 months.

• 

  Figure 2 Anterior segment optical coherence tomography and Pachymetry map finding in postoperative 9 months. (A) Previous corneal perforation site was well repaired after amniotic membrane transplantation (yellow arrows: previous corneal perforation site). (B) Mild thinning around previous perforation site was found and other peripheral cornea revealed no definite thinning. OD = oculus dexter; Min. = minimum; Avg. = average; Max. = maximum.

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