May 31, 2019 Conference


Outcomes of Cyanoacrylate Tissue Adhesive Application in Corneal Thinning and Perforation

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Dr. Rohan Singh, Massachusetts Eye and Ear Infirmary (Presenter)
Ms. Ann Yung, Massachusetts Eye and Ear Infirmary
Dr. Jia Yin, Mass Eye and Ear Infirmary
Dr. Reza Dana

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Authors: Rohan Bir Singh1, Ann Yung1, Jia Yin1, Reza Dana1

Affiliation: 1- Cornea Center of Excellence, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA

Methods: A chart review of 10,052 patients treated for corneal thinning, perforation or descemetocele at Massachusetts Eye and Ear from January 2006 to January 2018 was performed. The data from 137 patients treated with Cyanoacrylate glue was recorded and analyzed.

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Results: Median age of the cohort was 63 years and 69 (50%) were female. One hundred fifteen patients (84%) had at least one systemic condition, 46 (34%) had autoimmune diseases. Eighty-nine eyes (64%) presented with perforation while 51 (36%) with thinning. The perforation/thinning was central/paracentral in 82 eyes (59%) and peripheral in 57 eyes (41%). The median size of perforation was 3.1 mm2. Causes of perforation and thinning were a microbial infection in 75 (55%), sterile melt in 49 (35%), laceration in 10 and keratoprosthesis melt in 8 eyes. Median glue retention was 58 days. The success rate of glue application (defined as an intact globe without surgical intervention) was 72%, 61% and 46% at 10, 30 and 90 days post-glue application, respectively. The larger size of perforation/thinning, perforation (vs. thinning) and single glue application (vs. multiple) were correlated with a higher failure rate. Systemic conditions, use of topical corticosteroid, etiologies and location of perforation/thinning were not significantly correlated with glue failure.

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Conclusion: CTA application was moderately effective in stabilizing corneal perforation and thinning in the very short-term. Multiple applications are often required. Maintenance of globe integrity after glue application decreases with time and the need for

surgical intervention remains high.