Efficacy of cyanoacrylate tissue adhesive in the management of corneal thinning and perforation due to microbial keratitis

Singh, Rohan Bir; Zhu, Shouping; Yung, Ann; Dohlman, Thomas H.; Dana, Reza; Yin, Jia

doi:10.1016/j.jtos.2020.08.001

Cited by 16 publications

(10 citation statements)

References 24 publications

(24 reference statements)

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“…However, in vivo studies are ongoing, and results are showing no evidence of cytotoxicity and moreover show that cyanoacrylates have good tissue integration, effective short‐term biocompatibility, and a low macrophage response in animal and human subjects 16 . There are also increasing reports of the use of cyanoacrylate in vascular surgery or in the treatment of fistulae, varices, and ocular conditions within human medicine 41–44 . Evidence promotes their use in dentistry and oral surgery, with closure of intraoral mucosal incisions being deemed easier and faster with synthetic sealants when compared to sutures, with equivalent overall outcome 45 .…”

Section: Discussionmentioning

confidence: 99%

Effects of cyanoacrylate on leakage pressures of cooled canine cadaveric jejunal enterotomies

Thompson,

Miller,

Bowlt Blacklock

2023

Veterinary Surgery

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ObjectiveTo compare the intraluminal initial and maximal pressures of enterotomies closed using three different techniques (single‐layer appositional continuous closure; closure with cyanoacrylate; a single‐layer appositional closure augmented with cyanoacrylate) in a cooled canine cadaveric jejunal model and to report the initial leak location in all samples.Study designExperimental, ex‐vivo study.Sample populationGrossly normal chilled small intestine segments from three canine cadavers.MethodsA total of 45 chilled jejunal segments (n = 15 segments/group) were assigned to a handsewn group (HSE), a cyanoacrylate only group (CE) and a handsewn and cyanoacrylate group (HS + CE). A 2 cm antimesenteric enterotomy was performed and closure with one of the above techniques. Initial leakage pressures (ILP), maximal intraluminal pressures (MIP) and initial leakage location were recorded by a single observer.ResultsHandsewn enterotomies leaked at higher ILP when augmented with cyanoacrylate (83.3 ± 4.6 mmHg, p < .001) compared to both the HSE group (43.8 ± 5.3 mmHg) and the CE group (18.6 ± 3.5 mmHg). Those sealed with cyanoacrylate only leaked at a lower MIP compared with the other groups (p < .001). Maximal intraluminal pressures did not differ between handsewn enterotomies, whether augmented or not (p = .19).ConclusionReinforcement of a sutured enterotomy closure with cyanoacrylate was easy to perform and resulted in significantly increased initial leak pressures in cadaveric jejunum.Clinical significanceThe increased leakage pressures achieved by reinforcing enterotomies with cyanoacrylate could consequently reduce the incidence of postoperative intestinal leakage following an enterotomy and may result in reduced patient morbidity or mortality.

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Section: Discussionmentioning

confidence: 99%

Effects of cyanoacrylate on leakage pressures of cooled canine cadaveric jejunal enterotomies

Thompson,

Miller,

Bowlt Blacklock

2023

Veterinary Surgery

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“…Исследование продемонстрировало умеренную краткосрочную протекторную эффективность цианоакрилатного клея, которая позволяла отсрочить кератопластику на 6 месяцев. По данным тех же авторов, применение цианоакрилатного клея позволило использовать местные кортикостероиды для подавления активного воспалительного процесса и последующего рубцевания роговицы [44]. Подобные результаты были получены группой авторов под руководством Jia Yin при лечении 137 пациентов с БК, также осложненном истончением/перфорацией роговицы.…”

Section: хирургическое лечениеunclassified

Bacterial Keratitis. Part 2. Topical Aspects of Treatment

et al. 2023

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Bacterial keratitis (BC) is a threatening condition for the anatomy and function of the eyeball and requires an immediate complex of therapeutic measures. Effective treatment that preserves the anatomical and functional result of the organ of vision, including various non-surgical and surgical methods, is the basis for the treatment of CD. Drug therapy includes, first of all, massive etiotropic therapy, which is usually represented by broad-spectrum antibiotics, antiseptics and anti-inflammatory drugs. These combinations make it possible to competitively influence all links of the pathological process, showing an additive effect. Promising non-surgical means in the fight against bacterial infection of the cornea, in particular with resistant microorganisms, is the use of Quantum dots, Mitomycin C, Matrix metalloproteinases. The most radical surgical methods of treatment are based on therapeutic keratoplasty, the purpose of which is to excise the infectious focus of the cornea and restore its transparency through transplantation of donor corneal tissue, but this method has a number of disadvantages and limitations in its implementation. Autoconjunctival keratoplasty is the oldest method of treatment of progressive corneal ulcers and this method should be considered rather as temporary or preparatory before through keratoplasty, due to the lack of visual functions. The least radical and relevant surgical methods of CD treatment today are the use of Corneal Crosslinking, Microdiathermocoagulation, Cyanoacrylate glue, Amniotic membrane transplantation. The expansion of the arsenal of methods of influencing the microbial process of the cornea and their further study will allow for a quick response in response to the rapidly developing antibiotic resistance in the world.

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“…Small corneal perforations and areas of thinning can be managed with cyanoacrylate glue. Glue can help maintain globe stability until infection resolves www.co-ophthalmology.com or until penetrating keratoplasty can be arranged and provides some bacteriostatic effect [74,75]. Conjunctival flaps are another option as they help maintain corneal integrity while providing a blood supply to support healing.…”

Section: Procedural and Surgical Therapiesmentioning

confidence: 99%

Therapy for contact lens-related ulcers

Jeang

Tuli

2022

Current Opinion in Ophthalmology

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Purpose of reviewThe current review covers the current literature and practice patterns of antimicrobial therapy for contact lens-related microbial keratitis (CLMK). Although the majority of corneal ulcers are bacterial, fungus and acanthamoeba are substantial contributors in CLMK and are harder to treat due to the lack of commercially available topical medications and low efficacy of available topical therapy.Recent findingsTopical antimicrobials remain the mainstay of therapy for corneal ulcers. Fluoroquinolones may be used as monotherapy for small, peripheral bacterial ulcers. Antibiotic resistance is a persistent problem. Fungal ulcers are less responsive to topical medications and adjunct oral or intrastromal antifungal medications may be helpful. Acanthamoeba keratitis continues to remain a therapeutic challenge but newer antifungal and antiparasitic agents may be helpful adjuncts. Other novel and innovative therapies are being studied currently and show promise.SummaryContact lens-associated microbial keratitis is a significant health issue that can cause vision loss. Treatment remains a challenge but many promising diagnostics and procedures are in the pipeline and offer hope.

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Efficacy of cyanoacrylate tissue adhesive in the management of corneal thinning and perforation due to microbial keratitis

Cited by 16 publications

References 24 publications

Effects of cyanoacrylate on leakage pressures of cooled canine cadaveric jejunal enterotomies

Effects of cyanoacrylate on leakage pressures of cooled canine cadaveric jejunal enterotomies

Bacterial Keratitis. Part 2. Topical Aspects of Treatment

Therapy for contact lens-related ulcers

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