Cyanoacrylate tissue gluing in corneal perforations associated with herpetic keratitis

Abstract Purpose To evaluate the success of cyanoacrylate tissue adhesive for the management of corneal perforations associated with herpetic keratitis. Methods Forty six eyes of 46 patients with microbiologically proven herpetic keratitis associated with corneal perforation were included in a retrospective analysis. N‐Butyl cyanoacrylate tissue adhesive and bandage contact lens were applied in addition to antiviral therapy. Outcome measure was the preservation of the structural integrity of the globe. Results After glue application, the corneal perforation healed with scar formation in only 12 (26%) eyes. Keratoplasty had to be performed in 32 eyes (70%) due to failure of the glue. Fourteen (31%) eyes required multiple applications of tissue adhesive. Two eyes underwent enucleation and 1 eye became phthisical. Conclusion Glue application for corneal perforation in cases of herpetic keratitis is not effective and most cases require a corneal graft to maintain the ocular structural integrity.