A case of pellucid marginal degeneration with corneal perforation successfully treated by primary suturing alone

Pellucid marginal degeneration (PMD) is a degenerative corneal condition that can lead to corneal perforation. A 55-year-old patient diagnosed with PMD presented to our hospital with a corneal perforation. The patient was initially treated using a therapeutic contact lens (CL) and pressure patch. The aqueous leak stopped, and anterior segment optical coherence tomography (AS-OCT) showed that the cornea had healed superficially. However, a significant gap remained in the stroma, indicating that the perforation would not heal with conservative treatment. Consequently, primary suturing using interrupted sutures was performed under local anesthesia, successfully repairing the perforated area and significantly improving visual acuity to 20/12.5 (vs. 20/250 before the corneal perforation). The AS-OCT examination revealed improvement in corneal astigmatism compared with the pre-perforation state. Thus, primary suturing is an effective treatment for spontaneous corneal perforation after PMD.