[Keratomalacia perforans, clinical and pathohistologic findings]

This report deals on the course of disease in an 82-year-old patient with keratomalacia perforans with seropositive chronic polyarthritis. In the more severely affected eye there was a marginal corneal ulcer extending over two quadrants and close to perforation. Six months after total keratoplasty, in which the corneal transplant including marginal scleral tissue was resected and transplanted, a recurrent ulcer was observed at the same location. It proved impossible to prevent rejection of the transplanted tissue despite therapy with antiphlogistic and immunsuppressive drugs. The ulcer subsequently perforated. Histologically a plasmacellular infiltration was observed which was more severe in the areas close to the perforation.