Role of Temporary Tarsorrhaphy Using Super Glue in the Management of Corneal Disorders

Abstract

 Purpose: To evaluate the safety and efficacy of temporary tarsorrhaphy using super glue in the management of corneal disorders.

Material and Methods: A retrospective chart review of 46 consecutive patients who underwent superglue tarsorrhaphy from June 1997 to June 1998 was performed. All patients were managed at the Institute of Ophthalmology, Mayo hospital, Lahore. This study included patients with painful non healing corneal ulcers, exposure keratopathy (secondary to moderate proptosis), dry eyes (to reduce surface area of evaporation) and post-operative patients with conjunctival flaps ± scleral grafts (to help take up of the graft). Patients with corneal perforations, endopthalmitis or panophthalmitis were excluded from the study. Temporary tarsorrhaphy was done using super glue technique in which the upper eyelashes were glued to the lower lid skin. The degree of lid closure was calculated according to the pre-existing corneal pathology. Patients were followed up on a weekly basis for one month to check for reduction of pain, improvement of corneal pathology and duration of tarsorrhaphy.

Results: There were 50 eyes of 46 patients included in the study who underwent super glue tarsorrhaphy for various corneal pathologies. There were 36 males and 10 female patients with an average age of 40 years (range 10-60 yrs). Thirty two eyes had keratitis (fungal, bacterial, disciform, dendritic), 5 had a persistent epithelial defect, 4 had exposure keratopathy secondary to moderate proptosis, 5 had conjunctival flap alone or combined with a scleral graft and 4 had dry eyes. In cases of keratitis the tarsorrhaphy remained intact for 2-3 weeks, in patients with proptosis it remained intact for 2 weeks and in cases of dry eyes and conjunctival graft it remained intact for 2-3 weeks. The most common complication seen in the majority of patients was loss of a few lashes after spontaneous opening of the tarsorrhaphy in 2-3 weeks time. Three patients required early opening of the tarsorrhaphy which was done by cutting the eyelashes. No patient had spillage of the glue onto the cornea.

Conclusion: Temporary tarsorrhaphy using super glue technique is a quick, painless and effective outdoor procedure in providing temporary relief in the management of different keratopathies, dry eyes and exposure keratopathy.