tissue adhesive + bcl in childrenwith microbial keratitis
TRANSCRIPT
Tissue Adhesive + BCL in children
with Microbial Keratitis
Tanuj R. Sharma
Mayur R. Moreker
Ashwin B. Bafna
Dhyanesh K. Desai
Rashmikant C. Patel
Taparia Institute of Ophthalmology
Bombay Hospital Institute of Medical Sciences
Dr. Tanuj R. SharmaTaparia Institute of OphthalmologyBombay Hospital Institute of Medical Sciences , Mumbai.
Cyanoacrylate glue
•Early application of cyanoacrylate glue with bandage
contact lens is known to aid management of small corneal
perforations, corneal melts and wound leaks.
•It may also avoid the need for tectonic penetrating
keratoplasty
Vote BJ, Elder MJ. Cyanoacrylate glue for corneal perforations: a description of a
surgical technique and a review of the literature
Clin Experiment Ophthalmol. 2000 Dec;28(6):437-42.
Dr. Tanuj R. SharmaTaparia Institute of OphthalmologyBombay Hospital Institute of Medical Sciences , Mumbai.
•Cyanoacrylate glue prevents collagenase production thus
preventing stromal melting.
•Cyanoacrylate also have significant bacteriostatic activity
against gram-positive organisms.
Cyanoacrylate glue
Vote BJ, Elder MJ. Cyanoacrylate glue for corneal perforations: a description of a
surgical technique and a review of the literature
Clin Experiment Ophthalmol. 2000 Dec;28(6):437-42.
Dr. Tanuj R. SharmaTaparia Institute of OphthalmologyBombay Hospital Institute of Medical Sciences , Mumbai.
Objective
To report use of Cyanoacrylate Tissue Adhesive and Bandage Contact Lens (TA + BCL) for urgent tectonic support to avert therapeutic keratoplasty in children with microbial keratitis and imminent / apparent perforation
Methods•Patient 1 (7 years) - Large perforated paracentral corneal infiltrate with endoexudates.•Patient 2 (10 years) - Paracentral corneal infiltrate with central descemetocoele, impending perforation. •Both underwent TA + BCL (AC Reformation in Patient 1) which averted therapeutic keratoplasty
Dr. Tanuj R. SharmaTaparia Institute of OphthalmologyBombay Hospital Institute of Medical Sciences , Mumbai.
Corneal Perforation
Endoexudates
Infiltrates
Patient 1 - Presentation
Culture: Fungus (Zygomycosis spp.)
Steps of Tissue Adhesive + Bandage Contact Lens ProcedurePRE - PROCEDURE DRYING THE FIELD WITH SPONGE
POST - PROCEDURE APPLICATION OF GLUE
Tissue Adhesive
Bandage CL
Day 1 post TA + BCL
Vascularized scar
Visual axis
3 months post TA + BCL
BCVA: 20/30
Impending Perforation
Infiltrate
Patient 2 - Presentation
Smear: Gram Negative Bacilli
Dr. Tanuj R. SharmaTaparia Institute of OphthalmologyBombay Hospital Institute of Medical Sciences , Mumbai.
Tissue Adhesive
Bandage CL
Immediate Post TA + BCL
Dr. Tanuj R. SharmaTaparia Institute of OphthalmologyBombay Hospital Institute of Medical Sciences , Mumbai.
Vascularized scar
Visual axis
2 months post TA + BCL
BCVA: 20/60
Dr. Tanuj R. SharmaTaparia Institute of OphthalmologyBombay Hospital Institute of Medical Sciences , Mumbai.
• Cyanoacrylate glue + Bandage Contact Lens offers urgent
tectonic support and helps avert urgent therapeutic
keratoplasty achieving excellent visual outcome in children
with paracentral corneal infiltrates
Conclusion
Thank you
Dr. Tanuj R. SharmaTaparia Institute of OphthalmologyBombay Hospital Institute of Medical Sciences , Mumbai.