Cyanoacrylate glue for corneal perforations: a description of a surgical technique and a review of the literature

Clinical and Experimental Ophthalmology - Tập 28 Số 6 - Trang 437-442 - 2000
Brendan J. Vote1, Mark Elder1
1Department of Ophthalmology, Christchurch Public Hospital, Christchurch, New Zealand.

Tóm tắt

ABSTRACTThe effective early application of a cyanoacrylate glue corneal patch can aid in the management of small corneal perforations, corneal melts and wound leaks. Their use gives improved visual outcomes with reduced enucleation rates (6%vs 19%). It may also avoid the need for tectonic penetrating keratoplasty.Cyanoacrylate glue prevents re‐epithelialization into the zone of damaged and naked stroma and prevents the development of the critical setting for collagenase production that leads to stromal melting. Cyanoacrylates also have significant bacteriostatic activity against Gram‐positive organisms.We describe a simple and easily reproducible method of cyanoacrylate corneal patch application, with neglible risk of inadvertent glue complications. It has the further advantage of a smooth corneal surface rather than an irregular surface as often occurs with direct application methods.With corneal application, the major concern is toxicity of cyanoacrylates through direct contact with the corneal endothelium and lens. Fibrin glues may be less toxic; however, they are not as readily available. The longer alkyl chains of currently available cyanoacrylate glues (e.g. Histoacryl) slows degradation significantly, limiting accumulation of histotoxic by‐products to amounts that can be effectively eliminated by tissues. Vigilance in monitoring for infection/corneal infiltrate is necessary at all times, especially when the glue has been present for more than 6 weeks.Corneal patching with cyanoacrylate glue is a temporizing procedure only, buying time to allow healing secondary to medical treatment of the underlying condition, or allowing surgery to be elective and under more optimal conditions once inflammation has been reduced and the integrity of the globe restored.

Từ khóa


Tài liệu tham khảo

10.1016/S0161-6420(82)34742-9

10.1001/archopht.1968.00980050647013

10.1016/0002-9394(69)94067-7

Hirst LW, 1979, Tissue adhesives: new perspectives in corneal perforations., Ophthalmic Surg., 10, 58

Trott AT., 1997, Cyanoacrylate tissue adhesives – an advance in wound care., JAMA, 277, 1559, 10.1001/jama.1997.03540430071037

10.1016/S0886-3350(13)80141-1

10.1016/0002-9394(80)90168-3

Dohlman CH, 1969, Artificial corneal epithelium in acute alkali burns., Ann. Ophthalmol., 1, 357

Kiyoo N., 1990, [Interaction between corneal invasion of polymorphonuclear leukocytes and corneal epithelium.], Nippon Ganka Gakkai Zasshi, 94, 445

10.1001/archopht.1983.01040010958022

10.1016/S0161-6420(83)34508-5

10.1016/0002-9394(87)90249-2

10.1016/S0161-6420(93)31674-X

Golubovic S, 1990, Cyanoacrylate glue in the treatment of corneal ulcerations., Fortschr. Ophthalmol, 87, 378

Markowitz GD, 1995, Corneal endothelial polymerisation of histoacryl adhesive: a report of a new intraocular complication., Ophthalmic Surg., 26, 256

10.1159/000413622

10.3109/15563658909038580

10.1007/BF02569064

10.1016/S0161-6420(82)34649-7

Wessels IF, 1989, Applicator for cyanoacrylate tissue adhesive., Ophthalmic Surg., 20, 211

Quillen DA, 1994, Aerosol application of cyanoacrylate adhesive., J. Refract. Corneal. Surg., 10, 149, 10.3928/1081-597X-19940301-15

Erdey RA, 1991, Techniques for application of tissue adhesive for corneal perforations., Ophthalmic Surg, 22, 352

Gauthier L, 1989, Use of a fibrin glue (Tissucol) for treating perforated or pre‐perforated corneal ulcer., J. Fr. Ophthalmol, 12, 469

Thông tin
Thông tin xuất bản

Clinical and Experimental Ophthalmology

Tập 28 Số 6

437-442

Thông tin tác giả