Use of sealant (HFG) in corneal perforations

Purpose: To repair corneal perforation using human fibrin glue and determine its efficacy. Methods: A case series study was performed on corneal performed on corneal performation up to 3 mm in diameter who were admitted in Farabi Eye Hospital. Age, visual acuity, presence and size of corneal thinning, corneal epithelial defect, size and depth of corneal infiltration, site and size of corneal perforation, corneal vascularization, anterior chamber depth, and reaction and the etiology of corneal peforation were recorded. Then, corneal peforation was sealed using FG and soft contact lens, and the patients were followed up for at least 3 months. Healing of the corneal perforation with adhesive was considered as a success (the primary outcome) and reported. Results: Of 18 patients, 8 were women and 10 men. The mean age of the patients was 52 +/- 25.7 years. The size of corneal perforations was 0.6-3 mm (mean = 1.88 mm). the etiologies of corneal perforation were postinfectious in 11 and noninfectious in 7. Fifteen (83.3%) eyes had successful healing of corneal perforation after 3 months. All the patients who were failed had corneal perforation larger than 2 mm in diameter. The success rate was higher in corneal perforation <= 2 mm in diameter. No case developed giant papillary conjunctivitis or secondary glaucoma. Only 1 (5.6%) eye showed a signigicant increase in deep corneal vascularization. Conclusions: FG is effective in the closure of corneal perforations up to 2 mm in diameter. Corneal perforation larger than 2 mm may not respond well. It provides fast healing with low rate of corneal vascularization.