Tissue adhesive therapy for corneal perforations

The current indications for and method of application of tissue adhesive are described. A method for an expanded utilisation of tissue adhesive is discussed. To study the effect of the introduction of tissue adhesive to The Wilmer Institute in 1974, the records of 104 consecutive non-traumatic corneal perforations or descemetoceles admitted to The Wilmer Institute from 1960 to 1980 were assessed retrospectively with follow-up being obtained from records or from referral physicians for 87 of these perforations. Forty-nine percent of the cases were caused by bacterial corneal ulcers, 13% by exposure, 12% by chemical burns, 6% by fungal keratitis, 5% by herpes simplex keratitis, and 15% were undiagnosed. Since the introduction of tissue adhesive in 1974, there has been an apparent trend towards a lower enucleation rate (6%) in the tissue adhesive treated group compared with 19% in perforations treated by other therapies.