A case of paracentral corneal perforation treated with one-bite-mini-keratoplasty

A 61-year-old man presented corneal perforation of 1.0 mm in diameter in his right eye caused by a metallic foreign body fragment. We used “one-bite-mini-keratoplasty” technique that applies a host-graft-host cornea patch with a single suture to stop aqueous humor leakage. Postoperatively, the graft was completely epithelialized. The suture was removed and the use of soft contact lens was discontinued. Postoperative best-corrected visual acuity (BCVA) recovered to 180/200 and corneal astigmatism was 0.6 diopters. The postoperative course was unremarkable, but corneal perforation recurred because of an ocular bruise due to patient’s carelessness during the 17-month follow-up. He was reoperated using the same technique. His BCVA was 160/200 and corneal astigmatism was 1.1 diopters after reoperation. This surgical technique was performed twice for corneal perforation, but optimal visual function can be maintained even after 2 years. For paracentral corneal perforations, our simple technique may reduce astigmatism and maintain high visual function.