Clinical experience with N-butyl cyanoacrylate tissue adhesive in corneal perforations secondary to herpetic keratitis.
OBJECTIVE
To evaluate the success of cyanoacrylate tissue adhesive in the management of corneal perforations associated with herpetic keratitis.


METHODS
Case records of 46 patients with microbiologically proven herpetic keratitis associated with corneal perforations that were treated with corneal gluing were analyzed retrospectively in a tertiary care hospital. N-Butyl cyanoacrylate tissue adhesive and bandage contact lens were applied in addition to antiviral therapy. The main outcome measure was preservation of the structural integrity of the globe.


RESULTS
Glue application could heal corneal perforations in only 17 eyes (37%). Therapeutic keratoplasty had to be performed in 26 eyes (57%) because of failure of the glue. Fourteen eyes (31%) required multiple applications of tissue adhesive, and 2 eyes had to be eviscerated. Location of perforation, additional anterior chamber intervention, and use of prophylactic acyclovir therapy had no statistically significant effect on the overall final outcome.


CONCLUSIONS
Corneal perforations associated with herpetic keratitis may not heal with glue application alone, and corneal transplantation surgery may be required to maintain the ocular structural integrity.
Royal Victorian Eye and Ear Hospital, Department of Ophthalmology, East Melbourne, Victoria, Australia.
Sonia
S
Moorthy
Vishal
V
Jhanji
Marios
M
Constantinou
Jacqueline
J
Beltz
Enrique O
EO
Graue-Hernandez
Rasik B
RB
Vajpayee
D000212:Acyclovir / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use; D057112:Corneal Perforation / Q000188:drug therapy* / Q000209:etiology; D004659:Enbucrilate / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D016849:Keratitis, Herpetic / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014014:Tissue Adhesives / Q000627:therapeutic use*; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects*
D000998:Antiviral Agents; D014014:Tissue Adhesives; D004659:Enbucrilate; D000212:Acyclovir