{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T06:11:19Z","timestamp":1760076679895,"version":"build-2065373602"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:00:00Z","timestamp":1760054400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease often associated with ocular manifestations. In rare cases of RA, paracentral rheumatoid corneal perforation may occur. We report the case of a 53-year-old monocular woman with a 20-year history of RA who presented to the clinic with a paracentral corneal perforation. Slit-lamp examination revealed a 2-mm diameter paracentral perforation with an iris plug. The patient was clinically diagnosed with sterile rheumatoid corneal perforation. We describe an innovative \u201csandwich\u201d procedure developed for addressing the corneal perforation. Initially, a partial thickness limbal groove was created outside the perforation, followed by the formation of a semicircular intrastromal pocket extending approximately 2\u202fmm inside the perforation edge. A lamellar graft was then fashioned and inserted into the intrastromal pocket. Subsequently, the limbal groove was closed, and a conjunctival flap was used to cover the perforated area. Upon follow-up, the \u201csandwich\u201d procedure provided sufficient tectonic support for the patient\u2019s only eye, resulting in a stable ocular surface. Over a 6-year follow-up period, the postoperative best-corrected visual acuity (BCVA) was maintained at 20\/50. To the best of our knowledge, this is the first report of the \u201csandwich\u201d procedure for paracentral rheumatoid corneal perforation.<\/jats:p>","DOI":"10.3389\/fmed.2025.1649417","type":"journal-article","created":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T05:28:14Z","timestamp":1760074094000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The \u201csandwich\u201d procedure for paracentral rheumatoid corneal perforation: a case report with 6-year follow-up and literature review"],"prefix":"10.3389","volume":"12","author":[{"given":"Yi","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanjing","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qing","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-guang","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,10]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1038\/nrrheum.2013.185","article-title":"Ocular inflammatory diseases associated with rheumatoid arthritis","volume":"10","author":"Artifoni","year":"2014","journal-title":"Nat 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