Application of cyanoacrylate glue in corneal impending perforation (descemetocele) under slit lamp biomicroscope

A male in his sixties had been treated outside initially as right eye suspected viral stromal keratitis with oral acyclovir and topical prednisolone 1% and later as suspected microsporidial stromal keratitis with oral albendazole, topical voriconazole 1% and topical prednisolone 1%. In our management, we have ruled out microsporidia by corneal scraping, restarted antiviral treatment, and stopped topical prednisolone in view of the epithelial defect. The patient slowly improved with the complete disappearance of the infiltrates, but there was a persistent epithelial defect that turned into a descemetocele. Hence, we have performed cyanoacrylate glue application on the descemetocele under a slit lamp biomicroscope in outpatient department (OPD) settings. In this case report, we have demonstrated and educated the important steps and precautions in the corneal tissue adhesive glue application under a slit lamp biomicroscope in OPD settings.