All India Institute of Medical Sciences, Bathinda, Punjab.
Nepal J Ophthalmol. 2020 Jan;12(23):56-65. doi: 10.3126/nepjoph.v12i1.25003.
This study was conducted to characterize morphological and functional outcome of application of tissue adhesive (TA) in corneal perforations.
This is a retrospective study in which data of corneal perforations which were managed by application of TA (N- butyl cyanoacrylate) from January 2015 to April 2018 were reviewed. The final outcome of TA in corneal perforation was considered as sealed or non-sealed over a period of three months. Criteria of success of TA application included resolution of infiltrates, corneal vascularisation and scarring. Morphological outcome was considered as corneal scarring, required therapeutic penetrating keratoplasty (TPK) and loss of anatomical integrity of globe as phthisis bulbi. Functional success was considered preservation of visual function with best corrected visual acuity (BCVA).
A total of sixty seven eyes of sixty seven patients were reviewed in the present study. The mean age of all the patients was 46.63 ±16.30 years (range: 5-81 years) with predominance of males 41(61.19%). Infective keratitis (IK) constituted major chunk of aetiology for corneal perforations 44(65.67%) with maximum 47(70.14%) of size of ≥1.5-3.0mm. 56(83.58%) cases sealed completely, rest 11(16.41%) cases failed to seal. Morphological outcome showed significant relationship with age, number of glue applications and complications with P value (0.05, 0.00, 0.00) respectively. The functional outcome showed significant relationship with age, frequency of applications, morphological outcome and complications (p value 0.02, 0.00, 0.00, 0.00) respectively.
Infective keratitis is major cause of corneal perforations. Corneal perforations ≤3.0mm size shows healing and subsequent closure in 83.58%. Morphological and functional outcome shows significant relationship with age, number of glue applications and complications.
本研究旨在描述应用组织粘合剂（TA）治疗角膜穿孔的形态学和功能结果。
这是一项回顾性研究，其中回顾了 2015 年 1 月至 2018 年 4 月期间应用 TA（丁基氰基丙烯酸酯）治疗的角膜穿孔患者的数据。在三个月的时间内，将 TA 在角膜穿孔中的最终结果视为密封或未密封。TA 应用成功的标准包括浸润、角膜血管化和瘢痕的消退。形态学结果考虑为角膜瘢痕、需要治疗性穿透性角膜移植（TPK）和眼球解剖完整性丧失（眼球萎缩）。功能成功被认为是保持视觉功能和最佳矫正视力（BCVA）。
本研究共回顾了 67 例 67 只眼。所有患者的平均年龄为 46.63±16.30 岁（范围：5-81 岁），男性占 41 例（61.19%）。感染性角膜炎（IK）是角膜穿孔的主要病因，占 44 例（65.67%），最大穿孔直径为 47 例（70.14%），为 1.5-3.0mm。56 例（83.58%）完全封闭，其余 11 例（16.41%）未封闭。形态学结果与年龄、胶用量和并发症均有显著关系（P 值分别为 0.05、0.00、0.00）。功能结果与年龄、应用频率、形态学结果和并发症均有显著关系（P 值分别为 0.02、0.00、0.00、0.00）。
感染性角膜炎是角膜穿孔的主要原因。直径≤3.0mm 的角膜穿孔愈合率为 83.58%。形态学和功能结果与年龄、胶用量和并发症显著相关。
