The Efficacy of N-Butyl-2 Cyanoacrylate (Histoacryl) for Sealing Corneal Perforation: A Clinical Case Series and Review of the Literature
|Jackie Tan1*, Yi-Chiao Li1,2, John Foster3 and Stephanie L Watson1|
|1Save Sight Institute, University of Sydney, Australia|
|2Geelong Hospital, Victoria, Australia|
|3Bio/Polymer Research Group, School of Biotechnology and Biomolecular Sciences, the University of New South Wales|
|Corresponding Author :||Jackie Tan
Save Sight Institute
Sydney Eye Hospital, Australia
Tel: +61 431735162
|Received February 25, 2015, Accepted April 15, 2015, Published April 20, 2015|
|Citation: Tan J, Li Y, Foster J, Watson SL (2015) The Efficacy of N-Butyl-2 Cyanoacrylate (Histoacryl) for Sealing Corneal Perforation: A Clinical Case Series and Review of the Literature. J Clin Exp Ophthalmol 6:420. doi: 10.4172/2155-9570.1000420|
|Copyright: © 2015 Tan J, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
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Purpose: To investigate the efficacy of corneal gluing procedures for corneal perforations of mixed aetiologies in a tertiary eye hospital in Sydney, Australia.
Design: Retrospective case series.
Methods: Episodes of corneal gluing procedures were identified from the Sydney Eye Hospital surgical database over 42 months from January 2010. All gluing procedures in this study were conducted in the operating theatre. Categorical variables were compared using Pearson’s chi-square test.
Results: Forty-five episodes of corneal gluing using n-butyl-2-cyanoacrylate were identified from 30 eyes. 18 eyes were glued once, 9 eyes were glued twice and 3 eyes were glued thrice. The median duration of butylcyanoacrylate adhesion was 14 days, range 1 to 1945 days. Our data yielded an episodic success rate of 67% for nbutyl- 2-cyanoacrylate gluing when success was defined as the tissue adhesive sealing the leak until healing by scarring or until planned definitive surgery. Secondary outcomes included success rate by the location, aetiology, and size of the corneal perforation, and did not reach statistical significance. Of our 30 eyes treated with nbutyl- 2cyanoacrylate glue, 47% (n=14) did not require further surgical intervention and healed by scarring. The complications noted with n-butyl-2-cyanoacrylate use were cornea vascularisation (n=5), conjunctival and corneal irritation (n=2), and secondary microbial keratitis (n=1).
Conclusions: Corneal gluing using n-butyl-2-cyanoacrylate was successful in 67% of episodes. Almost half of our eyes healed without surgical intervention. Corneal gluing, previously thought to be a temporising measure, is effective and can potentially be a definitive treatment.