Efficacy and safety of ethyl-2-cyanoacrylate adhesives for corneal gluing

Background: Ethyl-2-cyanoacrylate adhesive has been widely used for sealing small corneal perforations in Thailand. However, its efficacy has not been reported.

Objective: To study the efficacy and safety of ethyl-2-cyanoacrylate adhesive for corneal gluing in impending or perforated corneas.

Methods: This is a retrospective study of a case series of patients who had corneal gluing with ethyl-2-cyanoacrylate in a tertiary care center in Thailand from 1992-2010. Data includes demographic data, indications for treatment, visual acuity before and after gluing, number of gluing, definite treatment, success and complications after gluing.

Results: Sixty-six eyes were treated with ethyl-2-cyanoacrylate adhesive. There were 39 men (59%) and 27 women (41%). Age ranged from 11 to 87 years (mean age 49.74 years). The most common indications were perforated corneal ulcer (32%) and descemetocele (29%). Overall success rate of gluing was 91% (n = 60). Success rate on the first, second, third, and fifth attempt of gluing was 70% (n = 46), 14% (n = 9), 6% (n = 4), and 2% (n = 1), respectively. Definite treatments were performed on 17 patients after gluing. Six patients had penetrating keratoplasty, 6 had lamellar keratoplasty, 3 had amniotic membrane transplantation, 1 had corneal resuturing, and 1 immunocompromised patient with a severe corneal infection had an evisceration. One patient developed corneal irritation. No serious complications were found.

Conclusion: Ethyl-2-cyanoacrylate adhesive is safe and efficacious in gluing both noninfectious and infectious corneal perforations.