BACKGROUND: Generally, corneal perforations of 2 mm in diameter or greater are treated using graft material for tectonic support. A surgical technique for the primary repair of such perforations without the use of any additional tissue is presented. METHODS: This procedure is demonstrated by a case report. The technique involves creation of an elliptical defect out of a circular one, thus allowing for primary closure, with the addition of glue. A definitive penetrating keratoplasty was subsequently performed with several important modifications described herein. RESULTS: A water-tight closure was obtained with this technique for 1 month while the inflammation subsided. Preoperative visual acuity was light perception. One year postoperatively, it was count fingers at 8 feet with mild irregular astigmatism. CONCLUSION: This technique is useful for perforations which are central, larger than 2 mm in diameter, and when corneal or scleral material is not readily available for patch grafting.