Sadiq Salman N, Cartes Cristian, Sarfraz Muhammad N, Figueiredo Francisco C
Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK.
Departamento Especialidades, Facultad de Medicina, Unidad Oftalmologia, Universidad de la Frontera, Temuco, Chile.
Ophthalmol Ther. 2023 Dec;12(6):3403-3413. doi: 10.1007/s40123-023-00785-y. Epub 2023 Aug 17.
The purpose of this study was to report the success and long-term outcomes of cyanoacrylate tissue adhesive (CTA) application in the management of corneal perforation disorders.
This retrospective case series describes the profile and outcomes of eyes that underwent CTA for corneal perforation over an 11-year period from January 2009 until January 2020 at a tertiary eye centre in the United Kingdom.
In total, 25 eyes underwent CTA application during the study period. Non-traumatic sterile corneal melt was responsible in more than half of the cases (56.0%; n = 14) followed by infection (32.0%; n = 8) and trauma (12.0%; n = 3). Median size of perforation was 2.0 mm (interquartile range, IQR 1.0-3.0). The most common anatomical location of corneal perforation was central (56.0%; n = 14). Ocular surface disease was seen in almost all eyes except two (92.0%; n = 23) with dry eye disease being the most common (48.0%; n = 12). Amongst 23 eyes that completed follow-up (median 27 months; IQR 9.5-46.5), single CTA application was successful in achieving intact globe in 13 (56.5%) eyes and repeat gluing sealed total of 20 (86.9%) eyes. Survival analysis showed cumulative success of 71.0% and 51.2% at 90 and 250 days, respectively. The CTA was retained in the eyes for median of 94.0 days (IQR 30.0-140.5). A total of five patients developed adverse events, including endophthalmitis (n = 2), following CTA application.
CTA was highly effective in sealing corneal perforations in acute setting and showed moderate long-term success. However, multiple applications are often required.
本研究旨在报告氰基丙烯酸酯组织粘合剂（CTA）在角膜穿孔性疾病治疗中的成功率和长期疗效。
本回顾性病例系列描述了2009年1月至2020年1月在英国一家三级眼科中心接受CTA治疗角膜穿孔的眼部情况和治疗结果。
在研究期间，共有25只眼接受了CTA治疗。超过半数的病例（56.0%；n = 14）是由非创伤性无菌角膜溶解引起的，其次是感染（32.0%；n = 8）和创伤（12.0%；n = 3）。穿孔的中位大小为2.0毫米（四分位间距，IQR 1.0 - 3.0）。角膜穿孔最常见的解剖位置是中央（56.0%；n = 14）。除两只眼外，几乎所有眼睛都有眼表疾病（92.0%；n = 23），其中最常见的是干眼症（48.0%；n = 12）。在完成随访的23只眼中（中位随访时间27个月；IQR 9.5 - 46.5），单次CTA应用成功使13只眼（56.5%）实现眼球完整，重复粘贴使总共20只眼（86.9%）封闭。生存分析显示，在90天和250天时的累积成功率分别为71.0%和51.2%。CTA在眼中保留的中位时间为94.0天（IQR 30.0 - 140.5）。共有5例患者在CTA应用后出现不良事件，包括眼内炎（n = 2）。
CTA在急性情况下密封角膜穿孔非常有效，并显示出一定的长期成功率。然而，通常需要多次应用。
