We report a case of Fuchs marginal keratitis with a recurrence and spontaneous perforation on the lamellar graft. A constellation of marginal corneal infiltrates and stromal thinning under a pseudopterygium characterize this condition. Two years after an initial lamellar keratoplasty, the pathology recurred within the graft. A repeat lamellar keratoplasty was performed, this time combined with a conjunctival autograft.
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