ESCRS - PP14.01 - To Report An Unusual Case Of Dislocation Of Cyanoacrylate Glue Into The Anterior Chamber And Its Management

To Report An Unusual Case Of Dislocation Of Cyanoacrylate Glue Into The Anterior Chamber And Its Management

Published 2022 - 40th Congress of the ESCRS

Reference: PP14.01 | Type: Case report | DOI: 10.82333/4swr-vb06

Authors: Ritika Mukhija* 1 , Maytyra Trim 1 , Mayank A. Nanavaty 1

1Ophthalmology,Sussex Eye Hospital,Brighton,United Kingdom

To report an unusual case of dislocation of cyanoacrylate glue into the anterior chamber and its management

Tertiary care eye hospital

An 83 year-old lady who had previously undergone right eye penetrating keratoplasty (PK) for viral keratitis presented to our eye casualty with one week history of painful blurring of vision. Examination of right eye revealed infero-nasal graft melt with possible infiltrates and multiple loose sutures along with a flat anterior chamber (AC). The cornea was hazy, making measurement of dimensions of corneal melt and further intra-ocular examination difficult. Eye was extremely soft to touch and careful B-scan ultrasound revealed 360 degrees serous choroidal detachment. She underwent emergency cyanoacrylate adhesive and bandage contact lens placement in her right eye to restore ocular integrity and was also listed for an emergency PK. On two subsequent follow-up visits, the area of corneal melt had started to heal with a well-formed AC; however, on the third follow-up which was about five weeks after the procedure, though the corneal melt was noted to have healed well with better clarity of  surrounding cornea, the glue to be found to be inside the AC. Patient was then taken up for glue removal as an emergency procedure to prevent any long-term toxicity to the intra-ocular structures. During the procedure, glue was found to be adherent to the intra-ocular lens (IOL), which necessitated IOL explant. Following the procedure, the eye settled well with residual scarring and an uncorrected visual acuity of 6/60, which improved to 6/18 with pin-hole and normal intra-ocular pressure.

We discuss a unique case of late dislocation of cyanoacrylate adhesive into the anterior chamber, which had to be managed with IOL explant. This highlights the possible but rare complication and sequel of using tissue adhesives in cases with large corneal melt.