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Comparison of eye patching with cyanoacrylate glue application for anterior chamber reformation in infected perforated corneal ulcers

Objectives: This study was designed with the primary objective to compare between eye patching and cyanoacrylate glue application for anterior chamber (AC) reformation in infected perforated corneal ulcers. Subjects and Methods: This is a nonrandomized prospective comparative study conducted in a tertiary eye hospital. Patients with perforated keratitis were offered either eye patching (Group 1) or cyanoacrylate gluing (Group 2) under hospital admission and medical treatment to reform the AC. Success was defined as a formed AC at the time of discharge from the hospital. Patients were followed up to 1 month after discharge. Normally distributed data were expressed as mean ± standard deviation and skewed data as median. Nominal data between the two groups were compared using Chi-square test or Fisher's exact test. Results: Forty eyes underwent eye patching and 38 eyes cyanoacrylate gluing to reform the AC. The number of eyes with formed AC was more in Group 2 (92%) compared to Group 1 (70%) (P = 0.020). Subgroup analysis on the basis of the size of perforation and size of ulcer showed that AC reformation was better in Group 2 compared to Group 1 in all aspects [Table 1]. In intragroup analysis, success in Group 1 was significantly better in small perforations (P = 0.001) and in small ulcers (P = 0.032) and ulcer in central location (P = 0.004). In Group 2, there was no significant difference in AC reformation between small and large perforation or ulcer. In both groups, AC reformation in peripheral perforations was poor compared to central and paracentral perforations (P = 0.004, 0.032). Conclusions: Cyanoacrylate glue is better than eye patching to restore ocular integrity. However, eye patching showed promising results in subgroup of patients with small perforated ulcers.{Table 1}