Cytomegalovirus (CMV) infection is a significant clinical concern in newborns, immunocompromised patients with acquired immunodeficiency syndrome (AIDS), and patients undergoing immunosuppressive therapy or chemotherapy. CMV infection affects many organs, such as the lungs, digestive organs, the central nerve system, and eyes. In addition, CMV infection sometimes occurs in immunocompetent individuals. CMV ocular diseases includes retinitis, corneal endotheliitis, and iridocyclitis. CMV retinitis often develops in infected newborns and immunocompromised patients. CMV corneal endotheliitis and iridocyclitis sometimes develop in immunocompetent individuals. Systemic infections and CMV ocular diseases often require systemic treatment in addition to topical treatment.

Pellucid marginal degeneration (PMD) is a degenerative corneal condition that can lead to corneal perforation. A 55-year-old patient diagnosed with PMD presented to our hospital with a corneal perforation. The patient was initially treated using a therapeutic contact lens (CL) and pressure patch. The aqueous leak stopped, and anterior segment optical coherence tomography (AS-OCT) showed that the cornea had healed superficially. However, a significant gap remained in the stroma, indicating that the perforation would not heal with conservative treatment. Consequently, primary suturing using interrupted sutures was performed under local anesthesia, successfully repairing the perforated area and significantly improving visual acuity to 20/12.5 (vs. 20/250 before the corneal perforation). The AS-OCT examination revealed improvement in corneal astigmatism compared with the pre-perforation state. Thus, primary suturing is an effective treatment for spontaneous corneal perforation after PMD.