Clinical experience with butyl-2-cyanoacrylate adhesive in the management of canine and feline corneal disease.

Abstract

PURPOSE: To examine and evaluate clinical indications and postoperative outcome in a series of small animal patients in which corneal disease was managed by the application of butyl 2-cyanoacrylate adhesive. MATERIALS AND METHODS: In this retrospective study all small animal patients were identified that presented to the Royal Veterinary College, University of London over a 2-year period, in which corneal disease was managed by the application of butyl 2-cyanoacrylate. Indications for application, complicating factors prior to gluing, glue retention time, postoperative comfort, and extent of subsequent corneal reaction and scarring were noted for each case. Long-term follow-up data concerning visual and cosmetic outcome were obtained from owners and referring veterinarians. RESULTS: Thirty-seven patients (28 dogs and 9 cats), in which 39 eyes were treated, were identified. Indications for corneal gluing in this series included stromal ulceration (26/39 eyes); descemetocele (4/39 eyes); corneal laceration/foreign body (5/39 eyes); lamellar keratectomy (3/39 eyes) and superficial ulceration (1/39 eyes). At least one factor responsible for initiation, persistence or progression of the ulcer was identified in 66.7% of eyes prior to corneal gluing. These included keratomalacia; confirmed bacterial keratitis; corneal edema related to endothelial disease and keratoconjunctivitis sicca. Cyanoacrylate was generally well tolerated by patients with only 8/34 eyes demonstrating transient blepharospasm and increased lacrimation postoperatively. Retention time of cyanoacrylate varied widely from < 1 week to approximately 6 months, but was < 2 months in the majority (89%) of eyes. Exaggerated corneal vascularization was an infrequent postoperative complication, noted in only six canine eyes, and did not appear to be related to initial corneal disease, glue retention time or breed. CONCLUSIONS: Butyl 2-cyanoacrylate offers a convenient, economical and effective alternative to other treatment modalities, such as conjunctival grafts, in the management of corneal defects in canine and feline patients.