Cyanoacrylate glue treatment for persistent aqueous leak following postkeratoplasty relaxing incisions with compression sutures

Management of small perforated corneal ulcers: Training model in mammalian eye to enhance surgical skills of residents

PURPOSE

To demonstrate a training technique on the mammalian eye for optimum Cyanoacrylate Tissue adhesive application in cases of perforated corneal ulcers.

METHODS

A full-thickness defect simulating a perforation was created on the goat's eye cornea to teach the technique of cyanoacrylate glue application in cases of corneal perforations to novice surgeons.

RESULTS

This training model on the mammalian eye was tested by 10 residents at our centre. All the 10 candidates involved in our series were newly joined Cornea fellows with proficient skill in cataract surgeries and minor ophthalmic procedures such as suture removal, chalazion excision, pterygium removal and administration of an intravitreal injection. None of the candidates had prior experience of corneal surgeries. Each resident made an average of 4.4 attempts to seal the corneal defect, obtain a regular corneal surface and form the anterior chamber.

CONCLUSION

This training model helps in mastering one of the skills of corneal surgeries.

Late Follow-Up of Cyanoacrylate Usage in Cardiothoracic Surgery

In cardiovascular and thoracic surgery, troublesome bleeding and sternal dehiscence can be life-threatening if not managed appropriately. We used commercially available cyanoacrylate adhesive 21 times in 20 sporadic patients for the management of 6 different problems: sternal gluing in 7 cases; anastomotic line reinforcement and bleeding control with a glued Teflon or pericardial patch in 6; right ventricular or superior vena caval patch repair in 5; and 1 case each of left ventricular apical glued Teflon felt, arterial wall reinforcement, and control of air leakage after lung surgery. The mean age of the patients was 55.7 ± 12.5 years, ranging from 34 to 71 years. Successful results were obtained in 18 patients and 17 were alive on follow-up at 7.7 ± 5.5 months (range, 2 to 16 months). We used two different commercial brands of adhesive but obtained good results with only one of these preparations. Although commercially available cyanoacrylate is a new adjunct to cardiac surgery with documented safety and lifesaving results at negligible cost, the appropriate polymer for best results needs to be defined.

A sticky sight: cyanoacrylate 'superglue' injuries of the eye

A 64-year-old man presented to casualty with blurred vision and pain in his left eye, 2 h after inadvertently instilling clear nail glue into his eye instead of postoperative Timolol eye drops. The glue was removed at the slit lamp revealing a corneal abrasion, which was managed with topical antibiotics. Inadvertent ocular cyanoacrylate, or 'superglue', instillation has been reported frequently since 1982 when superglue was repackaged into ophthalmic style dropper bottles. This case report highlights the continuing problem of cyanoacrylate eye injuries and serves as a reminder to healthcare professionals to report such incidents to manufacturers and regulatory bodies, on behalf of their patients, to promote the introduction of universal safety mechanisms on all household chemical containers. Failure of glue manufacturers to introduce safety cap mechanisms has resulted in significant ocular morbidity over the last 27 years, and such incidents are expected to occur until superglue bottles are redesigned.

Twenty-five years of contact lenses: the impact on the cornea and ophthalmic practice

PURPOSE

The history of contact lenses has occurred in the latter half of the 20th century. In particular, events in the 1970s through the 1980s related to the invention of soft, hydrogel contact lenses have revolutionized the contact lens industry and the eye care attached to it. This article recounts that history from the perspective of market forces, inventions, and discoveries about the physiologic functioning of the cornea.

METHODS

The relevant literature is critically reviewed.

RESULTS

Discoveries about the oxygen needs of the cornea and consumer pressure for clear, comfortable, around-the-clock vision have resulted in a history of rigid gas permeable and soft lenses that leads to today's contact lens picture. The short-term and long-term effects of chronic hypoxia and the levels of lens oxygen transmissibility necessary to avoid them have been well-described. The advent of the soft lens, followed by the "human experiment" with initial extended-wear modalities, led to the advent of the disposable soft contact lens.

CONCLUSIONS

In the past 25 years, the development and wide acceptance of soft contact lenses have revolutionized the management of refractive error and corneal diseases.