Purpose: To examine the efficacy and safety of using cyanoacrylate in procedures to close corneal perforations.
Patients and methods: Consecutive patients at Miyata Eye Hospital who underwent procedures using cyanoacrylate to close corneal perforations between January 2018 and May 2020 after conservative treatment had failed were investigated. Patients' demographic information, cause of corneal perforation, size of corneal perforation, corneal thickness, best-corrected visual acuity, and complications before treatment and at 1, 3, 6, and 12 months after treatment were retrospectively reviewed from medical records.
Results: Ten eyes from 10 patients (age, 62.7±22.7 years) were included in the study. The primary causes of corneal perforation were as follows: bacterial keratitis (two eyes), persistent corneal epithelial defect (two eyes), trauma (two eyes), peripheral corneal ulceration associated with rheumatoid arthritis (one eye), dry eye associated with graft-versus-host disease (one eye), nasal duct occlusion (one eye), and unknown (one eye). The mean perforation size was relatively small, 0.74±0.55 mm (range: 0.2-2.0 mm). In 8 of 10 eyes, the perforation was closed successfully. Of the two eyes that did not respond, one underwent penetrating keratoplasty and the other underwent enucleation. Multiple cyanoacrylate applications were required in three eyes. Corneal vascular invasion was observed in three eyes. Corneal thickness at the perforated site increased in all patients whose perforation was closed successfully, and the increase was statistically significant at 1, 3, 6, and 12 months after treatment.
Conclusion: Closing corneal perforations using cyanoacrylate is considered effective for small corneal perforations.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 125: 579-585, 2021.