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New research · Ophthalmology
Korean journal of ophthalmology : KJO · 2d
Cohort studyKorean journal of ophthalmology : KJO · 2026

Clinical Characteristics, Management, and Visual Outcomes of Spontaneous Corneal Perforation: A Single-Center Retrospective Study in South Korea.

Hwi Yeong Yoon, Joon Young Hyon, Hyun Sun Jeon
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OphthalmologyCohort study

Infectious corneal perforation was linked to significantly worse final vision than non-infectious cases.

Clinical Characteristics, Management, and Visual Outcomes of Spontaneous Corneal Perforation: A Single-Center Retrospective Study in South Korea.

Hwi Yeong Yoon … Hyun Sun Jeon
Korean journal of ophthalmology : KJO · 2026
Purpose

To describe the clinical characteristics, etiologies, management patterns, and visual outcomes of spontaneous corneal perforation.

Methods

We retrospectively reviewed 18 eyes of 17 patients with spontaneous corneal perforation treated at a tertiary center in South Korea between 2014 and 2022 with follow-up through December 2024.

n = 18 eyes
Results

infectious cases ended with much worse final eyesight

Non-infectious
0.86logMAR
Infectious/mixed
2.19logMAR
More results

The mean patient age was 58.0 ± 25.1 years.

Primary surgical treatments included amniotic membrane transplantation (50%), corneal patch graft (38.9%), and penetrating keratoplasty (16.7%), with 38.9% requiring more than one procedure.

More results

Final visual acuity was significantly correlated with age (Spearman's ρ = 0.738, P = 0.003); patients with systemic comorbidities also showed significantly worse outcomes (P = 0.008), a finding that may partly reflect confounding by age.

“
Conclusion · 1 of 3

Spontaneous corneal perforation shows distinct clinical patterns by etiology and age.

Conclusion · 2 of 3

Younger patients with non-infectious disease achieved more favorable visual outcomes, while older patients with infectious or mixed etiologies more often required repeated interventions focused on globe preservation.

Conclusion · 3 of 3

Early recognition and sustained management of blepharokeratoconjunctivitis in younger patients and close monitoring of corneal integrity in older patients with neurotrophic keratopathy may reduce the risk of progression to perforation.

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