Spontaneous corneal perforation in a patient with unusual unilateral pellucid marginal degeneration

A 56-year-old man presented with acute loss of vision and tearing in his le ft eye. Slitlamp examination demonstrated peripheral corneal edema extendin g between the 2 and 6 o'clock positions as well as a perforation located in feriorly. The right eye was unremarkable. An emergent crescentic lamellar k eratoplasty was performed. The patch graft remained clear during the 30-mon th follow-up, and visual acuity improved significantly. No changes occurred in the right eye. This case represents an unusual, unilateral corneal ecta tic disorder, most likely pellucid marginal degeneration. (C) 2001 ASCRS an d ESCRS.