Cyanoacrylate adhesive closure of wound leaks following fornix-based trabeculectomy with adjunct 5-fluorouracil

Conjunctival wound leaks in the early postoperative period present a significant management problem following trabeculectomy with 5-fluoroura-cil (5-FU). Twelve patients who developed persistent leaks in fomix-based conjunctival flaps were treated with cyanoacrylate adhesive and a bandage contact lens. Injections of 5-FU were continued with the adhesive in situ in all of these patients. The combination of adhesive and 5-FU injections did not appear to interfere with conjunctival healing, but corneal epithelial and/or conjunctival changes were observed in all patients who received three or more adhesive applications. With a mean follow up of 11.4 (±3.4) months, nine patients (75%) were considered clinical successes. Mean intraocular pressure was 12.4 (±5.8) mm Hg in the successful group. Persistent postoperative wound leaks can therefore be managed with cyanoacrylate adhesive as an alternative to resuturing, and 5-FU therapy can be continued under close observation with the adhesive in place.