Cyanoacrylate tissue adhesive augmented tenoplasty: A new surgical procedure for bilateral severe chemical eye burns

Purpose, To report on cyanoacrylate tissue adhesive augmented tenoplasty, a new surgical procedure for bilateral severe chemical eve injuries. Methods , A 26-year-old man presented with bilateral severe (grade IV) chemical bur ns involving the eye, periorbital tissues, face, and neck. Despite adequate medical therapy, corneal, limbal, and scleral ulceration progressed in bot h eyes. Secondary Pseudomonas keratitis necessitated therapeutic penetratin g keratoplasty in the right eye. Tenoplasty and glued-on rigid gas permeabl e contact lens were unsuccessful to arrest progression of corneolimbosclera l ulceration in the left eye. We applied n-butyl cyanoacrylate tissue adhes ive directly on the ulcerating corneal, limbal, and scleral surface to augm ent tenoplasty. Results, The left ocular surface healed with resultant mass ive fibrous tissue proliferation and symblepharon on the nasal side. Ocular surface rehabilitation resulted in a vascularized leukomatous corneal opac ity with upper temporal clear cornea. The patient achieved visual acuity of 6/36 in the left eye. Conclusion. We suggest that cyanoacrylate tissue adh esive-augmented tenoplasty can be undertaken to preserve ocular integrity a nd retain visual potential in a severe chemical eye injury.