case_images: PMC4860975_01
case_images: Slit lamp photograph of the right eye. The pupil is dilated and slightly displaced superiorly and the anterior chamber is slightly shallow. There is an opaque corneal ulcer with gray edges. The iris is tented forward and adherent to the perforation site. Corneal vascularization is evident in the paracentral and inferotemporal areas.
case_images: JOVR-11-108-g001.jpg
case_images: PMC4860975_01_JOVR-11-108-g001.jpg
case_images: F1
case_images: Slit lamp examination revealed a small Seidel-positive corneal perforation approximately 1.5 mm x 1 mm in size in her right eye [Figure 1].
case_images: Appearance of the same eye as in Figure 1, after multilayer amniotic membrane transplantation (graft and patch) to seal the corneal perforation.
case_images: JOVR-11-108-g002.jpg
case_images: PMC4860975_01_JOVR-11-108-g002.jpg
case_images: F2
case_images: Multilayer amniotic membrane transplantation (AMT) was performed to seal the corneal perforation [Figure 2].
case_images: The corneal perforation remained sealed after resorption of the amniotic membrane.
case_images: JOVR-11-108-g003.jpg
case_images: PMC4860975_01_JOVR-11-108-g003.jpg
case_images: F3
case_images: The corneal perforation was sealed for 3 weeks following resorption of the AMT [Figure 3].
case_images: Recurrent corneal perforation developed three months after amniotic membrane transplantation.
case_images: JOVR-11-108-g004.jpg
case_images: PMC4860975_01_JOVR-11-108-g004.jpg
case_images: F4
case_images: However, corneal perforation recurred six months later [Figure 4].
case_images: Appearance of the right eye one week after penetrating keratoplasty together with a deep intrastromal injection of bevacizumab.
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case_images: PMC4860975_01_JOVR-11-108-g005.jpg
case_images: F5
case_images: Penetrating keratoplasty (PK) together with a deep subconjunctival and intrastromal bevacizumab injection in the donor cornea were performed simultaneously in the right eye [Figure 5].
case_images: Photomicrograph displaying different histopathological changes involving the cornea: corneal vascularization (a), corneal intrastromal inflammation (b), stromal corneal edema (c), and stromal corneal degeneration (d).
case_images: JOVR-11-108-g006.jpg
case_images: PMC4860975_01_JOVR-11-108-g006.jpg
case_images: F6
case_images: The corneal bottom was sent for histopathologic and bacteriologic evaluations which revealed corneal vascularization, inflammation, stromal edema and stromal degeneration [Figure 6].
case_images: Appearance of the left eye, three years following therapeutic lamellar keratoplasty and a deep intrastromal injection of bevacizumab.
case_images: JOVR-11-108-g007.jpg
case_images: PMC4860975_01_JOVR-11-108-g007.jpg
case_images: F7
case_images: With maximum ocular and systemic treatment, the graft remained clear during the subsequent three years [Figure 7].