# Full‐Thickness Corneal Perforation Secondary to Monopolar Cautery Burn During Cosmetic Blepharoplasty in a Young Adult: Successful Management With Cyanoacrylate Glue

## TL;DR

A rare case of corneal perforation during eyelid surgery was successfully treated with cyanoacrylate glue, preventing further vision loss.

## Contribution

Demonstrates successful management of a rare corneal perforation using cyanoacrylate glue during cosmetic blepharoplasty.

## Key findings

- Cyanoacrylate glue effectively sealed a full-thickness corneal perforation.
- Immediate tectonic stabilization preserved globe integrity and prevented infection.
- Visual acuity improved to 20/200 after treatment.

## Abstract

Thermal corneal injuries are uncommon but potentially vision‐threatening. Full‐thickness corneal perforation caused by monopolar electrocautery during cosmetic blepharoplasty is exceptionally rare and scarcely reported in the literature. We report a 27‐year‐old healthy man who sustained an accidental central full‐thickness corneal perforation during elective upper eyelid blepharoplasty due to inadvertent contact with monopolar cautery. The patient presented with severe ocular pain, markedly reduced vision, and a shallow anterior chamber. Prompt intervention was performed under sterile conditions. The corneal perforation was sealed using N‐butyl cyanoacrylate tissue adhesive, followed by placement of a bandage contact lens. Adjunctive topical and systemic medications were administered to prevent infection, control inflammation, and inhibit collagenolysis. At one‐week follow‐up, the adhesive remained intact with a stable anterior chamber and no evidence of leakage or infection. Visual acuity improved to 20/200, limited by central stromal opacity. Although long‐term follow‐up was unavailable, immediate tectonic stabilization was successfully achieved. This case highlights a rare but severe ocular complication of cosmetic blepharoplasty. Early recognition and rapid application of cyanoacrylate glue can effectively preserve globe integrity in small corneal perforations. Proper ocular protection is essential during periocular surgical procedures to prevent such catastrophic injuries.

Full‐thickness corneal perforation secondary to monopolar cautery burn during blepharoplasty is an exceptionally rare but vision‐threatening complication. Immediate recognition and rapid sealing with cyanoacrylate glue can preserve globe integrity, prevent infection, and provide time for definitive visual rehabilitation. Proper intraoperative ocular protection is essential.