• Journal of Veterinary Clinics
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• v.32 no.4
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• pp.356-358
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• 2015

When severely large corneal perforation occurs, penetrating keratoplasty is a treatment of choice alternative to enucleation. A twelve-year-old male Shih Tzu was referred with perforated corneal ulcer secondary to keratoconjunctivitis sicca (KCS). Perforated cornea was directly sutured using 10-0 non-absorbable suture material, and rotational conjunctival flap was performed. However, re-perforation of cornea by wound dehiscence was observed at 1 month after operation. The yellowish lens escaped outside the orbit during corneal re-perforation, the diagnosis was re-perforated corneal ulcer, moderate corneal edema, moderate KCS (STT; 6 mm) and endophthalmitis caused by escaped lens outside orbit. Accordingly, penetrating keratoplasty (PK) and evisceration through corneal recipient site and intrascleral silicone ball prosthesis were carried out as the planned treatment, and resulted in good cosmetic improvement compared to enucliation. However, exposure of silicone ball occurred at the 9 months after the surgery due to the irritation of implant, thus enucleation was performed. In perforated large corneal ulcer with severe intraocular damage, evisceration with silicone ball insertion with PK would be alternative treatment choice to improve the cosmetic appearance.