5-Year Outcome Of Corneal Perforation Repair With Cyanoacrylate Glue.

To report the 5-year outcome of cyanoacrylate tissue glue application in corneal perforation repair.

A retrospective interventional case series review was done on patients treated at Queens Medical Center between 2020 and 2024.

Case records of 23 patients receiving cyanoacrylate glue for corneal perforation repair in 27 eyes between 2020 and 2024 were reviewed. Success rate, which was defined as an intact globe without surgical intervention at 30 days. and factors associated with glue outcome were analyzed.

The median age of the cohort was 50 years, with a wide age range of 20-92 years with an almost equal male-female ratio. 30% of the patients had autoimmune diseases. 17% had bilateral perforation, and 26% required repeat gluing. The perforation was central in 15%, peripheral in 63%, and the site was not mentioned in 12%.

The major cause of perforation was corneal melt (44.5%); other causes included infectious keratitis (15%), trauma (11%), keratoconus (11%), and wound leak (7.5%). Glue removal ranged from 19 to 128 days (median-73.5 days), and glue fell off in 5 to 125 days (median-65 days).

Glue was successful in 81.5%. Ugent therapeutic graft was required in 18.5% of the patients, and 11% eventually required late PKP for corneal scar.

Cyanoacrylate glue application was a quick and effective procedure for the management of corneal perforations in acute settings. Immune-mediated corneal melting was the major cause of perforation and required multiple gluing. A larger size of perforation and iris incarceration in the wound were correlated with a higher failure rate. Systemic conditions, etiologies, and location of perforation were not significantly correlated with glue failure.Urgent PTK was required in fever cases, those with larger perforation. However, patients with central corneal scarring needed PKP in the long term