July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
Use of cyanoacrylate glue in corneal thinning and perforation associated with infectious keratitis
Author Affiliations & Notes
  • shuyan zhu
    Ophthalmology, Massachusetts Eye and Ear Infirmary, Massachusetts, United States
    Harvard Medical School, Massachusetts, United States
  • Jia Yin
    Ophthalmology, Massachusetts Eye and Ear Infirmary, Massachusetts, United States
    Harvard Medical School, Massachusetts, United States
  • Rohan Bir Singh
    Ophthalmology, Massachusetts Eye and Ear Infirmary, Massachusetts, United States
    Harvard Medical School, Massachusetts, United States
  • Rani Al Karmi
    Ophthalmology, Massachusetts Eye and Ear Infirmary, Massachusetts, United States
    Harvard Medical School, Massachusetts, United States
  • Ann Yung
    Ophthalmology, Massachusetts Eye and Ear Infirmary, Massachusetts, United States
    Harvard Medical School, Massachusetts, United States
  • Man Yu
    Ophthalmology, Massachusetts Eye and Ear Infirmary, Massachusetts, United States
    Harvard Medical School, Massachusetts, United States
  • Reza Dana
    Ophthalmology, Massachusetts Eye and Ear Infirmary, Massachusetts, United States
    Harvard Medical School, Massachusetts, United States
  • Footnotes
    Commercial Relationships   shuyan zhu, None; Jia Yin, None; Rohan Singh, None; Rani Al Karmi, None; Ann Yung, None; Man Yu, None; Reza Dana, None
  • Footnotes
    Support  National Eye Institute 5K12EY016335
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 3231. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      shuyan zhu, Jia Yin, Rohan Bir Singh, Rani Al Karmi, Ann Yung, Man Yu, Reza Dana; Use of cyanoacrylate glue in corneal thinning and perforation associated with infectious keratitis. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3231.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose : Corneal perforation and severe thinning of the stroma (descemetocele) are ophthalmic emergencies that require prompt intervention to retain ocular integrity and visual function. Cyanoacrylate glue is a first-line, albeit off-label, treatment for corneal perforation. Infectious keratitis is a major cause of corneal perforation; and in this study, we examine the etiologies underlying corneal thinning and perforation associated with infectious keratitis, and the outcome of cyanoacrylate glue application in these cases.

Methods : A retrospective interventional case series of 74 patients with infectious keratitis who received CTA for corneal thinning and perforation between 2001 and 2018 at a single-center was reviewed. Infection was diagnosed clinically and/or based on culture, pathology or confocal microscopy findings. Success rate of glue application, defined as intact globe without surgical intervention, was reported.

Results : Median age of the cohort was 66.5 years and 44 (59.5%) were female. Forty-two eyes (56.8%) presented with perforation while 32 (43.2%) with thinning. The perforation/thinning was central/paracentral in 47 eyes (63.5%) and peripheral in 26 eyes (35.1%). Median size of perforation was 3.4 mm2. Etiologies underlying perforation/thinning were bacterial (62 eyes, 83.8%), viral (2), fungal (3), acanthamoeba (2), and polymicrobial (5 eyes). Infectious organisms were identified by culture of corneal scraping in 58 eyes (78.4%): Staphylococcal species (30), pseudomonas (10), streptococcal species (10), diphtheroids (8), other bacteria (12), fungus (1), and acanthamoeba (1). One case of acanthamoeba and one case of fungal keratitis were identified by confocal microscopy and pathology, respectively, despite initial negative culture results. Success rate of glue application was 70%, 61% and 49% at 10, 30 and 90 days post-glue application, respectively.

Conclusions : Bacterial infection underlies the majority of corneal thinning and perforations that require cyanoacrylate glue application in this series. Cyanoacrylate glue application is relatively successful in restoring globe integrity in the short term.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×