Role Of Bandage Contact Lens With Glue In Patients With Non-Responding Microbial Keratitis With Corneal Thinning Or Impending Perforation
Published 2025 - 43rd Congress of the ESCRS
Reference: PO502 | Type: Free paper | DOI: 10.82333/kpre-q031
Authors: Alvaro Juan Pablo Tovar Gomez* 1 , Antonio López García 2 , Laura García Posadas 2
1Cornea Service,Unidad Nacional de Oftalmología,Guatemala,Guatemala;Ocular Surface Group, Universidad de Valladolid,Instituto de Oftalmobiología Aplicada IOBA,Valladolid,Spain, 2Ocular Surface Group, Universidad de Valladolid,Instituto de Oftalmobiología Aplicada IOBA,Valladolid,Spain
Purpose
This study evaluates the efficacy of cyanoacrylate glue with a bandage contact lens (BCL) in managing microbial keratitis cases unresponsive to conventional treatment, with progressive corneal thinning or impending perforation.
Setting
Cornea clinic, Eye department, Tertiary care academic institution, India
Methods
Patients included had microbial keratitis that showed no response to treatment, with ulcer worsening and corneal thinning despite two weeks of therapy. The ulcer size, infiltrate dimensions, and presence of hypopyon were recorded. Cyanoacrylate glue with BCL was applied per standard protocol, and patients were followed up for one year.
Results
A total of 50 patients were included. At 1 week, 42 (84%) showed a significant reduction in infiltrate size, consolidation of exudates, and decreased hypopyon. Improvement was seen in 40% (20/50) at 2 weeks, 64% (32/50) at 3 weeks, and 80% (40/50) at 4 weeks. Perforation requiring keratoplasty occurred in 4 (8%), while adherent leucoma developed in 5 (10%) at 6 months. At 6 months and 1 year, leucomatous opacity was seen in 80% (40/50), with visual axis involvement in 50% (25/50). Post-procedure visual acuity improved to >20/200 in 50% and >20/60 in 20%. Pre-procedure acuity was HM-CF, showing significant improvement.
Conclusions
The application of cyanoacrylate glue with BCL effectively stabilizes corneal ulcers, reduces infiltrate size, and prevents perforation in most cases. While corneal opacity formation remains a concern, the procedure preserves anatomical integrity and improves functional vision in a significant proportion of patients.