Double Drape Tectonic Patch With Cyanoacrylate Glue in the Management of Corneal Perforation With Iris Incarceration

Gandhewar, Jaishree; Savant, Vijay; Prydal, Jeremy; Dua, Hs

doi:10.1097/ico.0b013e3182801809

Cited by 21 publications

(15 citation statements)

References 3 publications

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“…The prolapsed iris is covered with a circular disc of plastic drape without glue and this in turn is covered with a larger disc of plastic drape with cyanoacrylate glue. The second disc adheres to the corneal tissue around the first disc, which prevents the glue from directly adhering to the iris (Gandhewar et al, 2013). The epithelium usually grows under the glue and healing of the defect usually dislodges the glue.…”

Section: Tissue Adhesivesmentioning

confidence: 99%

Neurotrophic keratopathy

Dua

Said

Messmer

et al. 2018

Progress in Retinal and Eye Research

289

356

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Neurotrophic Keratopathy (NK) refers to a condition where corneal epitheliopathy leading to frank epithelial defect with or without stromal ulceration (melting) is associated with reduced or absent corneal sensations. Sensory nerves serve nociceptor and trophic functions, which can be affected independently or simultaneously. Loss of trophic function and consequent epithelial breakdown exposes the stroma making it susceptible to enzymatic degradation. Nerve pathology can range from attrition to aberrant re-generation with corresponding symptoms from anaesthesia to hyperaesthesia/allodynia. Many systemic and ocular conditions, including surgery and preserved medications can lead to NK. NK can be mild (epithelium and tear film changes), moderate (non-healing epithelial defect) or severe (stromal melting and perforation). Moderate and severe NK can profoundly affect vision and adversely impact on the quality of life. Medical management with lubricating agents from artificial tears to serum/plasma drops, anti-inflammatory agents, antibiotics and anti-proteases all provide non-specific relief, which may be temporary. Contact lenses, punctal plugs, lid closure with botulinum toxin and surgical interventions like tarsorrhaphy, conjunctival flaps and amniotic membrane provide greater success but often at the cost of obscuring sight. Corneal surgery in a dry ocular surface with reduced sensation is at high risk of failure. The recent advent of biologicals such as biopolymers mimicking heparan sulfate; coenzyme Q10 and antisense oligonucleotide that suppress connexin 43 expression, all offer promise. Recombinant nerve growth factor (cenegermin), recently approved for human use targets the nerve pathology and has the potential of addressing the underlying deficit and becoming a specific therapy for NK.

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Section: Tissue Adhesivesmentioning

confidence: 99%

Neurotrophic keratopathy

Dua

Said

Messmer

et al. 2018

Progress in Retinal and Eye Research

289

356

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“…[5][6][7][8][9] A procedure using a double layer of sterile plastic drape as a barrier between the glue and the AC has also been described. 10 Tenons patch grafts (TPGs) have been described in the repair of leaking trabeculectomy blebs, in the management of scleromalacia after pterygium excision, and in the repair of a traumatic scleral perforation. [11][12][13] The Tenons capsule begins about 2 mm posterior to the limbus and is composed of 2 parts.…”

mentioning

confidence: 99%

Tenons Patch Graft in the Management of Large Corneal Perforations

Korah

Selvin

Pradhan³

et al. 2016

Cornea

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“…These degradation byproducts can cause inflammatory reaction that manifest as scarring, vascularisation, symblepharon and giant papillary conjunctivitis [16]. Shorter alkyl side chains are hence thought to be more toxic [4].…”

Section: Discussionmentioning

confidence: 99%

“…Cyanoacrylates are increasingly used as tissue adhesives for corneal perforations. Sealing cornea perforations with cyanoacrylate glue is often regarded as a temporising measure buying time to treat infection, control inflammation and manage systemic diseases while awaiting favourable treatment environment [4].…”

Section: Introductionmentioning

confidence: 99%

The Efficacy of N-Butyl-2 Cyanoacrylate (Histoacryl) for Sealing Corneal Perforation: A Clinical Case Series and Review of the Literature

Foster¹

2015

J Clin Exp Ophthalmol

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Purpose: To investigate the efficacy of corneal gluing procedures for corneal perforations of mixed aetiologies in a tertiary eye hospital in Sydney, Australia. Design: Retrospective case series. Methods: Episodes of corneal gluing procedures were identified from the Sydney Eye Hospital surgical database over 42 months from January 2010. All gluing procedures in this study were conducted in the operating theatre. Categorical variables were compared using Pearson's chi-square test. Results: Forty-five episodes of corneal gluing using n-butyl-2-cyanoacrylate were identified from 30 eyes. 18 eyes were glued once, 9 eyes were glued twice and 3 eyes were glued thrice. The median duration of butylcyanoacrylate adhesion was 14 days, range 1 to 1945 days. Our data yielded an episodic success rate of 67% for nbutyl-2-cyanoacrylate gluing when success was defined as the tissue adhesive sealing the leak until healing by scarring or until planned definitive surgery. Secondary outcomes included success rate by the location, aetiology, and size of the corneal perforation, and did not reach statistical significance. Of our 30 eyes treated with nbutyl-2cyanoacrylate glue, 47% (n=14) did not require further surgical intervention and healed by scarring. The complications noted with n-butyl-2-cyanoacrylate use were cornea vascularisation (n=5), conjunctival and corneal irritation (n=2), and secondary microbial keratitis (n=1). Conclusions: Corneal gluing using n-butyl-2-cyanoacrylate was successful in 67% of episodes. Almost half of our eyes healed without surgical intervention. Corneal gluing, previously thought to be a temporising measure, is effective and can potentially be a definitive treatment.

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Double Drape Tectonic Patch With Cyanoacrylate Glue in the Management of Corneal Perforation With Iris Incarceration

Cited by 21 publications

References 3 publications

Neurotrophic keratopathy

Neurotrophic keratopathy

Tenons Patch Graft in the Management of Large Corneal Perforations

The Efficacy of N-Butyl-2 Cyanoacrylate (Histoacryl) for Sealing Corneal Perforation: A Clinical Case Series and Review of the Literature

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