Emulsion polymer isocyanate-gluing: Autologous epithelial transplant with cyanoacrylate glue application for small corneal perforations

Abstract

Cyanoacrylate glue (CG) is a commonly employed modality for sealing small corneal perforations. Presently, we describe the technique of emulsion polymer isocyanate (EPI)-gluing, a modification of its application, and its results in nine eyes with noninfectious, nontraumatic sterile corneal perforation with size ≤3 mm. The method involves harvesting a small patch of autologous epithelium adjacent to the melt area with the help of 10% alcohol and transplanting to the site of melt with its basement membrane facing downwards. CG, loaded on the reverse side of Sinskey hook or Weck-Cel sponge, is instilled on this epithelium-melt site complex and withdrawn immediately following which a bandage contact lens is placed on the corneal surface. In our series of patients with nine eyes where EPI-gluing was undertaken, all eyes reported a healed corneal scar with spontaneously dislodged glue and no underlying vascularization at 3-months follow-up. EPI-gluing is an inexpensive and host-friendly technique for the treatment of small noninfectious corneal perforations particularly with iris tissue prolapse.

Hitch suture assisted tuck in Tenon's Patch Graft for management of Corneal Perforations

“…The use of cyanoacrylate glue in conjunction with TPG or BCL often incites stromal vascularization and intraocular inflammation that puts the future graft at high risk. 13 The use of fibrin glue in our study compared to CAG in theirs possibly offered the advantage of being a biologically derived compound, reducing the likelihood of an inflammatory response. Another difference was the site of harvesting the graft, they harvested TPG from the inferior quadrant.…”

Anterior lens capsule: Biological drape

“…Bafna et al . [ 2 ] used epithelium from the adjacent cornea to provide additional tectonic layer to augment the cyanoacrylate glue. To the best of our knowledge, the use of anterior lens capsule has not been described previously.…”

“…[ 1 ] Various modifications have been described of the method: use of sterile drape and use of adjacent epithelium. [ 2 ] We describe use of anterior capsule as additional layer over which cyanoacrylate glue is applied.…”

Photocurable and Temperature‐Sensitive Bioadhesive Hydrogels for Sutureless Sealing of Full‐Thickness Corneal Wounds

“…Several adhesives, primarily developed as patches for placement only on the corneal surface, have been previously explored for sealing full-thickness corneal wounds. [30] However, when sutures are used for corneal wound closure, they should penetrate to a depth of 75% to 90% of the stroma to prevent the potential occurrence of a posterior wound gape. [31] Consequently, adhesive patches carry a high incidence of posterior wound gape when utilized for sealing penetrating corneal incisions.…”