Comparative Outcomes of Single Versus Multiple Cyanoacrylate Tissue Adhesive Applications in the Management of Corneal Thinning and Perforation
Bibliographic record
Abstract
PURPOSE: To compare outcomes between patients treated with a single cyanoacrylate tissue adhesive (CTA) patch for corneal thinning or perforation and those requiring multiple CTA applications. METHODS: We conducted a single-center, comparative cohort study of patients with corneal thinning or perforation treated with either a single or multiple CTA applications in Toronto, Canada, between 2006 and 2024. Primary outcomes were the need for penetrating keratoplasty (PKP) and the best-corrected visual acuity (BCVA) at final follow-up. Associations between the number of CTA applications with baseline characteristics, perforation characteristics, and final outcomes were analyzed using univariable and multivariable logistic regression models. RESULTS: Overall, 189 patients (median age 69.0 years; 42% female) were included, with 116 (61%) in the single CTA group and 73 (39%) in the multiple-application group (mean 2.3 ± 0.6), over a median follow-up of 4.4 months. Baseline characteristics were similar between groups. Central and paracentral corneal defects were more likely to require multiple glue applications than peripheral defects (OR = 2.92, 95% CI, 1.31-6.51, P = 0.009). No difference was observed in final BCVA between groups (median: 2.0 logarithm of the minimum angle of resolution [single] vs. 2.0 logarithm of the minimum angle of resolution [multiple]; P = 0.838). Patients receiving multiple CTA applications (48%, n = 35/73) were more likely to require PKP (OR = 2.70, 95% CI, 1.42-5.15, P = 0.003) than those treated with a single glue patch (26%, n = 30/116). CONCLUSIONS: Multiple CTA applications were more frequently needed for central/paracentral defects and were associated with a greater likelihood of PKP. Given no significant difference in final BCVA, a conservative, stepwise management approach can be pursued without compromising long-term visual outcomes, allowing flexibility in surgical planning.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".