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. 2023 Dec;12(6):3403-3413.
doi: 10.1007/s40123-023-00785-y. Epub 2023 Aug 17.

Outcomes of N-butyl-2-Cyanoacrylate Tissue Adhesive Application in Corneal Perforation Disorders: Consecutive Case Series

Salman N Sadiq  1 , Cristian Cartes  1   2 , Muhammad N Sarfraz  1 , Francisco C Figueiredo  3   4
Affiliations

Outcomes of N-butyl-2-Cyanoacrylate Tissue Adhesive Application in Corneal Perforation Disorders: Consecutive Case Series

Salman N Sadiq et al. Ophthalmol Ther. 2023 Dec.

Abstract

Introduction: The purpose of this study was to report the success and long-term outcomes of cyanoacrylate tissue adhesive (CTA) application in the management of corneal perforation disorders.

Methods: This retrospective case series describes the profile and outcomes of eyes that underwent CTA for corneal perforation over an 11-year period from January 2009 until January 2020 at a tertiary eye centre in the United Kingdom.

Results: In total, 25 eyes underwent CTA application during the study period. Non-traumatic sterile corneal melt was responsible in more than half of the cases (56.0%; n = 14) followed by infection (32.0%; n = 8) and trauma (12.0%; n = 3). Median size of perforation was 2.0 mm (interquartile range, IQR 1.0-3.0). The most common anatomical location of corneal perforation was central (56.0%; n = 14). Ocular surface disease was seen in almost all eyes except two (92.0%; n = 23) with dry eye disease being the most common (48.0%; n = 12). Amongst 23 eyes that completed follow-up (median 27 months; IQR 9.5-46.5), single CTA application was successful in achieving intact globe in 13 (56.5%) eyes and repeat gluing sealed total of 20 (86.9%) eyes. Survival analysis showed cumulative success of 71.0% and 51.2% at 90 and 250 days, respectively. The CTA was retained in the eyes for median of 94.0 days (IQR 30.0-140.5). A total of five patients developed adverse events, including endophthalmitis (n = 2), following CTA application.

Conclusions: CTA was highly effective in sealing corneal perforations in acute setting and showed moderate long-term success. However, multiple applications are often required.

Keywords: Corneal perforation; Cyanoacrylate; Outcomes; Tissue adhesive.

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Conflict of interest statement

Salman Naveed Sadiq, Cristian Cartes and Francisco C Figueiredo have no competing interests. Muhammad Numan Sarfraz’s new affiliation since this study is Kings College Hospital, London, United Kingdom.

Figures

Fig. 1
Fig. 1
Kaplan–Meier survival distribution curve representing CTA success of 31 applications (including 8 repeat) over time. CTA cyanoacrylate tissue adhesive
Fig. 2
Fig. 2
Kaplan–Meier survival distribution curve representing CTA success of 31 applications (including 8 repeat) over time comparing non-infectious (A) and infectious (B) groups. The differences were not statistically significantly (p = 0.13). CTA cyanoacrylate tissue adhesive
See this image and copyright information in PMC

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