Application of 2-octyl-cyanoacrylate for corneal perforation and glaucoma filtering bleb leak

Motonori Okabe,1 Kiyotaka Kitagawa,2 Toshiko Yoshida,1 Chika Koike,1 Takeshi Katsumoto,2 Etsuko Fujihara,2 Toshio Nikaido1 1Department of Regenerative Medicine, University of Toyama, Graduate School of Medicine and Pharmaceutical Sciences, Toyama, 2Division of Ophthalmology, Matsue Red Cross Hospital, Japanese Red Cross Society, Shimane, Japan Background: This paper reports on the efficacy of a tissue adhesive, 2-octyl-cyanoacrylate, in the treatment of corneal perforation and glaucoma filtering bleb leak. Methods: Two eyes from two patients with corneal perforation or laceration and two eyes from two patients with bleb leak were included. The patients underwent application of 2-octyl-cyanoacrylate onto the perforated or leaking site, and a hydrogel contact lens was applied as a bandage. We also evaluated the in vitro cell toxicity of 2-octyl-cyanoacrylate in HeLa cells. Results: The two cases of corneal perforation were repaired within 22 days with one application of the tissue adhesive. The two cases of bleb leak were repaired with 2–4 applications of the tissue adhesive over 134 (range 17–134) days). There were no recurrences or adverse effects during a mean follow-up period of 12.7 months. In vitro testing revealed that 2-octyl-cyanoacrylate was markedly toxic to HeLa cells. Conclusion: Four patients with corneal perforation or bleb leak were successfully managed using 2-octyl-cyanoacrylate tissue adhesive. This simple and easy surgical technique may become an alternative therapeutic option for corneal perforation or bleb leak, although several applications of this tissue adhesive may be required. Although 2-octyl-cyanoacrylate was toxic to HeLa cells, no adverse clinical effects were noted using this adhesive. Keywords: corneal perforation, bleb leak, tissue adhesive, 2-octyl-cyanoacrylate