Factors Influencing Cyanoacrylate Tissue Adhesive Outcomes for Corneal Thinning and Perforation

<i>Background and Objectives</i>: To report the outcomes of cyanoacrylate tissue adhesive (CTA) in patients with corneal perforations and thinning. <i>Materials and Methods</i>: A retrospective interventional study of 83 eyes treated with CTA for corneal thinning or perforati...

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Main Authors: Anjali Om, Anjali Badami, Yuqing Wang, Xiangqin Cui, Soroosh Behshad, Joung Kim, Praneetha Thulasi
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/3/492
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author Anjali Om
Anjali Badami
Yuqing Wang
Xiangqin Cui
Soroosh Behshad
Joung Kim
Praneetha Thulasi
author_facet Anjali Om
Anjali Badami
Yuqing Wang
Xiangqin Cui
Soroosh Behshad
Joung Kim
Praneetha Thulasi
author_sort Anjali Om
collection DOAJ
description <i>Background and Objectives</i>: To report the outcomes of cyanoacrylate tissue adhesive (CTA) in patients with corneal perforations and thinning. <i>Materials and Methods</i>: A retrospective interventional study of 83 eyes treated with CTA for corneal thinning or perforation at a single institution between 2010 and 2020. Primary endpoints leading to CTA failure, visual acuity, and surgical outcomes were evaluated. <i>Results</i>: At presentation, 55 (66%) had frank perforations and 28 (34%) had thinning or desmetocele. Univariate analysis showed that only multiple CTA applications were associated with CTA failure (<i>p</i> = 0.047). Multivariate analysis did not show any statistically significant variables associated with CTA failure. No variables were associated with the need for future surgery at 30 days or any further point. Older patients (<i>p</i> = 0.005), use of topical steroids before gluing (<i>p</i> = 0.03), corneal thinning (vs. perforation) (<i>p</i> = 0.02), location of pathology (<i>p</i> = 0.048), and multiple CTA applications (<i>p</i> = 0.046) were associated with worse visual outcomes in univariate analysis. Multivariate logistic regression analysis showed that older age (OR 1.05) and use of topical steroids before gluing (OR 3.84) showed higher odds, and systemic immunosuppression (OR 0.08) and single (versus multiple) CTA application (OR 0.11) showed lower odds of worse visual acuity (BCVA ≥ 20/200). The presence of an anterior chamber prior to gluing was associated with spontaneous dislocation of CTA (<i>p</i> = 0.015). Spontaneous dislocation versus manual removal of glue was not associated with final visual acuity (<i>p</i> = 0.7), nor was duration of glue on the cornea (<i>p</i> = 0.2). <i>Conclusions</i>: CTA remains a mainstay of management in patients with corneal thinning or perforation. Only multiple CTA applications were associated with CTA failure, and duration of glue on the cornea was not associated with final visual acuity.
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spelling doaj-art-c08523f27afa45ab8b3e496ceba86ea32025-08-20T02:42:22ZengMDPI AGMedicina1010-660X1648-91442025-03-0161349210.3390/medicina61030492Factors Influencing Cyanoacrylate Tissue Adhesive Outcomes for Corneal Thinning and PerforationAnjali Om0Anjali Badami1Yuqing Wang2Xiangqin Cui3Soroosh Behshad4Joung Kim5Praneetha Thulasi6Department of Surgery, Emory University, Atlanta, GA 30322, USAWashington Eye Specialists, Washington, DC 20017, USAGraduate Group in Epidemiology, University of California, Davis, CA 95616, USADepartment of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA 30329, USAGavin Herbert Eye Institute, Department of Ophthalmology, University of California, Irvine, CA 92617, USADepartment of Ophthalmology, Emory Eye Center, Emory University, Atlanta, GA 30322, USADepartment of Ophthalmology and Visual Sciences, Washington University in St. Louis, St. Louis, MO 63141, USA<i>Background and Objectives</i>: To report the outcomes of cyanoacrylate tissue adhesive (CTA) in patients with corneal perforations and thinning. <i>Materials and Methods</i>: A retrospective interventional study of 83 eyes treated with CTA for corneal thinning or perforation at a single institution between 2010 and 2020. Primary endpoints leading to CTA failure, visual acuity, and surgical outcomes were evaluated. <i>Results</i>: At presentation, 55 (66%) had frank perforations and 28 (34%) had thinning or desmetocele. Univariate analysis showed that only multiple CTA applications were associated with CTA failure (<i>p</i> = 0.047). Multivariate analysis did not show any statistically significant variables associated with CTA failure. No variables were associated with the need for future surgery at 30 days or any further point. Older patients (<i>p</i> = 0.005), use of topical steroids before gluing (<i>p</i> = 0.03), corneal thinning (vs. perforation) (<i>p</i> = 0.02), location of pathology (<i>p</i> = 0.048), and multiple CTA applications (<i>p</i> = 0.046) were associated with worse visual outcomes in univariate analysis. Multivariate logistic regression analysis showed that older age (OR 1.05) and use of topical steroids before gluing (OR 3.84) showed higher odds, and systemic immunosuppression (OR 0.08) and single (versus multiple) CTA application (OR 0.11) showed lower odds of worse visual acuity (BCVA ≥ 20/200). The presence of an anterior chamber prior to gluing was associated with spontaneous dislocation of CTA (<i>p</i> = 0.015). Spontaneous dislocation versus manual removal of glue was not associated with final visual acuity (<i>p</i> = 0.7), nor was duration of glue on the cornea (<i>p</i> = 0.2). <i>Conclusions</i>: CTA remains a mainstay of management in patients with corneal thinning or perforation. Only multiple CTA applications were associated with CTA failure, and duration of glue on the cornea was not associated with final visual acuity.https://www.mdpi.com/1648-9144/61/3/492corneal perforationthinninggluecyanoacrylate glue
spellingShingle Anjali Om
Anjali Badami
Yuqing Wang
Xiangqin Cui
Soroosh Behshad
Joung Kim
Praneetha Thulasi
Factors Influencing Cyanoacrylate Tissue Adhesive Outcomes for Corneal Thinning and Perforation
Medicina
corneal perforation
thinning
glue
cyanoacrylate glue
title Factors Influencing Cyanoacrylate Tissue Adhesive Outcomes for Corneal Thinning and Perforation
title_full Factors Influencing Cyanoacrylate Tissue Adhesive Outcomes for Corneal Thinning and Perforation
title_fullStr Factors Influencing Cyanoacrylate Tissue Adhesive Outcomes for Corneal Thinning and Perforation
title_full_unstemmed Factors Influencing Cyanoacrylate Tissue Adhesive Outcomes for Corneal Thinning and Perforation
title_short Factors Influencing Cyanoacrylate Tissue Adhesive Outcomes for Corneal Thinning and Perforation
title_sort factors influencing cyanoacrylate tissue adhesive outcomes for corneal thinning and perforation
topic corneal perforation
thinning
glue
cyanoacrylate glue
url https://www.mdpi.com/1648-9144/61/3/492
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