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Three Cases of Corneal Perforation Caused by Noncontact Tonometry

Purpose: The purpose of this study was to report 3 clinical features of corneal perforation induced in 3 separate patients by noncontact tonometry (NCT). Methods: Three cases are discussed along with the relevant literature. Results: The first patient had a necrotic cornea for a month after penetrating keratoplasty (PK) and developed a central corneal perforation induced by NCT. The wound in the first patient opened in the corneal center, and air bubble filled the anterior chamber. The wound was self-sealed after the administration of antibiotic eyedrops for 4 weeks. The second patient developed a traumatic corneal wound dehiscence after PK by NCT and underwent graft resuturing. The third patient developed expulsive choroidal hemorrhage after extracapsular cataract surgery by NCT and underwent the wound repair, iris reposition, anterior chamber reformation, and anterior vitrectomy the same day. Conclusions: NCT does not seem sufficiently safe in patients with a thin and necrotic cornea, or suture loosening after PK during the early postoperative period.