Abstract

Background: Corneal perforation is a vision-threatening ophthalmic emergency characterized by a full-thickness defect in the cornea, leading to loss of globe integrity and potential irreversible visual impairment. Prompt diagnosis and appropriate management are essential to restore anatomical integrity and preserve vision. The study was conducted to evaluate the clinical profile, etiological factors, management modalities, and outcomes of corneal perforation in a tertiary care hospital setting. Methods: This prospective observational study included 60 patients with fullthickness corneal perforation managed over 18 months at a tertiary care hospital. Patients were assessed for demographic characteristics, etiology, site, size, and clinical presentation. Management strategies included medical therapy, tissue adhesive with bandage contact lens (TABCL), Patch graft, amniotic membrane transplantation, and keratoplasty. Outcomes were evaluated based on anatomical integrity, epithelial healing, visual improvement, and complications over a followup period of up to three months. Results: The mean age was 53.27 ± 15.81 years, with a male predominance (60%). Post-infective causes were most common (45%), followed by trauma (30%) and autoimmune conditions (25%). Central perforations (45%) and small-sized defects <3 mm (60%) were predominant. TABCL was the most frequently employed treatment (50%), followed by keratoplasty (25%). Anatomical success was achieved in all cases (100%), with 92% epithelial healing. Visual improvement was observed in 40% of cases, with better outcomes in peripheral perforations (60%) compared to central ones (37%) (p = 0.0421). Post-procedural complications were minimal (10%).

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