A Retrospective Comparative Study Of Tissue Adhesive Application Versus Autologous Tenon’S Patch Graft In Corneal Perforations

To retrospectively study the outcome of autologous Tenon’s patch graft versus tissue adhesive application in corneal perforation

L.V Prasad Eye Institute, Bhubaneswar

We conducted age, gender, and indication-matched comparisons between two groups of subjects with corneal perforation (37 subjects each) who underwent Tenon's patch grafting (TPG) and Cyanoacrylate glue application (TABCL). Demographic and clinical data at presentation, etiological factors, visual acuity, site and size of perforation, use of systemic immunomodulators, and associated ocular comorbidities were recorded.  Anatomical outcome was analysed at 1 week and 1 month. 

The most common indications in both groups were immune stromal melts seen in dry eyes, Stevens-Johnson Syndrome(SJS), Infection, trauma, post-keratoplasty, and chemical burns. Systemic diagnoses were primarily Sjogren's disease, SJS, Vitamin A deficiency, Diabetes, and Hypertension. Patients were evaluated with detailed slit lamp examination and Serial AS-OCT during the follow-ups. The two groups were comparable at baseline with respect to demographic and clinical characteristics (p > 0.05). Anatomical success at 1 week was achieved in 94.6% (TPG) and 94.4% (TABCL) groups (p = 1.00). At 1 month, anatomical success was noted in 94.6% and 94.3% of eyes, respectively (p = 1.00), with no statistically significant difference between groups.

Both autologous Tenon’s patch grafting and cyanoacrylate glue application are simple and effective surgical techniques for restoring ocular integrity in corneal perforations. They are alternatives to amniotic membrane grafting and defer the need for keratoplasty.