Cyanoacrylate Adhesive for Retinal Tear Repair: A Contemporary Approach in Rhegmatogenous Retinal Detachment Surgery

To evaluate the use of cyanoacrylate adhesive for repairing a retinal tear in a patient with rhegmatogenous retinal detachment (RRD), focusing on anatomical and functional outcomes while exploring its advantages over traditional techniques.

A patient with a 20-day history of progressive visual decline in the left eye following previous unsuccessful vitrectomy for RRD. Fundus examination revealed inferior retinal detachment with multiple tears at 5 o'clock in areas of retinal pigment epithelium (RPE) atrophy secondary to multiple retinopexy procedures. Surgery involved a 23-gauge pars plana vitrectomy and use of perfluorocarbon liquid (PFCL) to stabilize the retina. A small amount of cyanoacrylate adhesive was applied to seal the retinal tears, followed by aspiration of PFCL and closure of sclerotomies. Since no tamponade was used, the patient was not required to maintain a prone position postoperatively. Follow-up evaluations were conducted over six months.

At two months follow up, the patient's visual acuity improved from hand motion to counting fingers. At six months, the retina remained attached 360°, with no evidence of proliferative vitreoretinopathy, subretinal migration of the adhesive, or other complications.

Cyanoacrylate adhesive demonstrated promising anatomical and functional outcomes in this complex RRD case. Its rapid adhesion, elimination of tamponade requirements, and avoidance of postoperative head positioning make it a valuable alternative in specific scenarios, especially for patients unable to comply with positioning protocols.