A Practical Approach to Corneal Perforation in the Absence of Donor Tissue

ABSTRACT: This case report presents an emergency surgical technique for managing a traumatic sealed corneal perforation in a young adult male, utilizing a sterile polydrape patch and cyanoacrylate glue. The objective was to showcase a straightforward, low-cost solution that can be especially useful in situations where donor corneal tissue is not readily available, such as in resource-limited environments or urgent care scenarios. A 22-year-old male sustained an ocular injury at his workplace following an accident involving a hand saw machine. He arrived with complaints of sudden visual decline, ocular pain, redness, and excessive tearing in his left eye. On clinical examination, a 4 mm × 3 mm sealed corneal perforation with pseudocornea was identified in the inferior quadrant, accompanied by a shallow anterior chamber and hypotony. Given the emergency and lack of access to corneal graft material, a temporary globe-sealing procedure was undertaken. A section of sterile surgical polydrape was punched into a 4 mm circular patch and carefully positioned over the perforation site. It was secured using N-butyl-cyanoacrylate glue, followed by the application of a bandage contact lens to enhance patient comfort and protect the surgical site. The patient's recovery was uneventful. At the 1-month review, the cornea had healed with a leucomatous scar at the perforation site. The anterior chamber was well maintained, and there were no signs of infection or persistent inflammation. In emergency settings or regions with limited access to donor corneas, the combination of a sterile polydrape patch and cyanoacrylate adhesive provides an effective and accessible method to restore globe integrity. This approach not only stabilizes the eye but also creates a critical window for healing or referral for definitive surgical management. It is a valuable interim solution, particularly in rural or under-resourced healthcare environments.