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Mironovich MA, Carter R, Chun Y, Foote BC, Van Horn Hendrix D, Lewin AC, Liu CC, Rogers C, Scott EM, Telle MR. Risk factors for corneal conjunctival grafting failure in dogs at four referral centers in the southern United States (203 patients): 2015-2021. Vet Ophthalmol 2024. [PMID: 38439580 DOI: 10.1111/vop.13204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/14/2024] [Accepted: 02/24/2024] [Indexed: 03/06/2024]
Abstract
OBJECTIVE To report risk factors associated with conjunctival graft failure in dogs at four referral specialty centers. PROCEDURES Records of 203 dogs (229 eyes) undergoing conjunctival graft repair of ulcerative keratitis at four hospitals from 2015 to 2021 were reviewed. Success was defined as full graft integration with globe retention at the last postoperative evaluation; vision status was reported separately. Factors assessed included patient signalment, ophthalmic examination findings, surgical factors, and follow-up information. RESULTS Conjunctival graft failure occurred in 11% (25/229) of eyes and was significantly associated with ulcer depth, with corneal perforations having increased odds of graft failure compared with descemetoceles (odds ratio [OR] = 3.22, 95% confidence interval [CI] 1.11-9.32; p = .03) and stromal ulcers (OR = 10.89 [95% CI 1.38-86.18], p = .02). Brachycephalic dogs were significantly more likely than non-brachycephalic dogs to experience graft failure (OR = 5.02 [95% CI 1.42-17.74], p < .01). Surgery on the opposite eye relative to surgeon handedness was significantly associated with an increased risk of graft failure (OR 4.28 [95% CI 1.53-11.94], p < .01). The use of 7-0 and 8-0 suture versus 9-0 (p = .03) and the use of a combined simple continuous and interrupted pattern (p = .03) were significantly associated with an increased risk of graft failure. At the last follow-up, (median 61.5 days), 87% of dogs were visual. CONCLUSIONS Corneal perforations, surgery on the opposite eye relative to surgeon handedness, suture size and pattern, and brachycephalic conformation were significantly associated with an increased risk of graft failure in this study. These characteristics can be considered when determining prognosis for ulcerative keratitis requiring surgical intervention.
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Affiliation(s)
- Melanie A Mironovich
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Renee Carter
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Yeji Chun
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Braidee C Foote
- College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee, USA
| | | | - Andrew C Lewin
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Chin-Chi Liu
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Callie Rogers
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Erin M Scott
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Mary R Telle
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
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Wang Q, Zhao X, Yu F, Fang PH, Liu L, Du X, Li W, He D, Bai Y, Li S, Yuan J. Photocurable and Temperature-Sensitive Bioadhesive Hydrogels for Sutureless Sealing of Full-Thickness Corneal Wounds. SMALL METHODS 2024; 8:e2300996. [PMID: 37997553 DOI: 10.1002/smtd.202300996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/19/2023] [Indexed: 11/25/2023]
Abstract
Penetrating corneal wounds can cause severe vision impairment and require prompt intervention to restore globe integrity and minimize the risk of infection. Tissue adhesives have emerged as a promising alternative to suturing for mitigating postoperative complications. However, conventional water-soluble adhesives suffer formidable challenges in sealing penetrating corneal wounds due to dilution or loss in a moist environment. Inspired by the robust adhesion of mussels in aquatic conditions, an injectable photocurable bioadhesive hydrogel (referred to as F20HD5) composed of polyether F127 diacrylate and dopamine-modified hyaluronic acid methacrylate is developed for sutureless closure of corneal full-thickness wounds. F20HD5 exhibits high transparency, wound-sealing ability, proper viscosity, biodegradability, and excellent biocompatibility. It allows in situ cross-linking via visible light, thereby providing sufficient mechanical strength and adhesiveness. In vivo, the adhesive hydrogel effectively closed penetrating linear corneal incisions and corneal injuries with minimal tissue loss in rabbits. During the 56-day follow-up, the hydrogel facilitates the repair of the injured corneas, resulting in more symmetrical curvatures and less scarring in distinction to the untreated control. Thus, bioinspired hydrogel holds promise as an effective adhesive for sealing full-thickness corneal wounds.
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Affiliation(s)
- Qian Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510623, China
| | - Xuan Zhao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510623, China
| | - Fei Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510623, China
| | - Po-Han Fang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510623, China
| | - Liu Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510623, China
| | - Xinyue Du
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510623, China
| | - Weihua Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510623, China
| | - Dalian He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510623, China
| | - Ying Bai
- Guangdong Engineering Technology Research Centre for Functional Biomaterials, School of Materials Science and Engineering, SunYat-sen University, Guangzhou, 510006, China
| | - Saiqun Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510623, China
| | - Jin Yuan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510623, China
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Dulaurent T, Rozoy M, Steun L, Isard PF. Multidirectional corneoconjunctival transposition in the treatment of large keratomalacia in 7 dogs and 5 cats. Vet Ophthalmol 2023. [PMID: 36943897 DOI: 10.1111/vop.13086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/14/2023] [Accepted: 03/02/2023] [Indexed: 03/23/2023]
Abstract
OBJECTIVE To describe the use of multidirectional corneoconjunctival transposition (CCT) as a surgical treatment for large keratomalacia. METHOD A prospective study including dogs and cats initially presenting with keratomalacia larger than 6 × 6 mm and affecting more than half of the corneal thickness. Signalment, concurrent eye diseases, ulcer size, bacterial culture and susceptibility testing results, follow-up, and outcome were recorded. The surgery consisted of harvesting of two or three opposite corneoconjunctival grafts, after removal of the malacic tissue using a square-edge keratectomy. The medical treatment consisted of administration of topical and systemic antibiotics, topical atropine, and N-acetylcysteine. Follow-up examinations were performed at D7, D14, D21, and D28, and then at various time points. The corneal clarity score (CCS) was recorded upon completion of the follow-up period. RESULTS Seven dogs and five cats were included. Brachycephalic dogs were overrepresented, with no breed predisposition in cats. Concurrent eye diseases were corneal pigmentation in three dogs, hypopyon in two dogs, nictitating membrane wound in one dog, and corneal perforation in one cat. The size of the keratomalacia ranged from 6 × 6 to 9.5 × 11.5 mm. The short-term complications were suture dehiscence (two of 12) and progression of the keratomalacia (one of 12). The long-term complications were corneal pigmentation (10 of 12), corneal epithelial inclusion cyst (two of 12), and marginal synechiae (one of 12). All animals were sighted at the last follow-up. The median CCS was G3 (range G2-G4). CONCLUSION Multidirectional CCT is an effective surgical treatment for large keratomalacia in dogs and cats.
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Affiliation(s)
- Thomas Dulaurent
- Centre Hospitalier Vétérinaire Saint-Martin, Allonzier-la-Caille, France
| | - Manon Rozoy
- Universitatea de Stiinte Agricole si Medicina Veterinara, Cluj-Napoca, Romania
| | - Laure Steun
- Centre Hospitalier Vétérinaire Saint-Martin, Allonzier-la-Caille, France
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Jia S, Bu Y, Lau DSA, Lin Z, Sun T, Lu WW, Lu S, Ruan C, Chan CHJ. Advances in 3D bioprinting technology for functional corneal reconstruction and regeneration. Front Bioeng Biotechnol 2023; 10:1065460. [PMID: 36686254 PMCID: PMC9852906 DOI: 10.3389/fbioe.2022.1065460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 12/19/2022] [Indexed: 01/09/2023] Open
Abstract
Corneal transplantation constitutes one of the major treatments in severe cases of corneal diseases. The lack of cornea donors as well as other limitations of corneal transplantation necessitate the development of artificial corneal substitutes. Biosynthetic cornea model using 3D printing technique is promising to generate artificial corneal structure that can resemble the structure of the native human cornea and is applicable for regenerative medicine. Research on bioprinting artificial cornea has raised interest into the wide range of materials and cells that can be utilized as bioinks for optimal clarity, biocompatibility, and tectonic strength. With continued advances in biomaterials science and printing technology, it is believed that bioprinted cornea will eventually achieve a level of clinical functionality and practicality as to replace donated corneal tissues, with their associated limitations such as limited or unsteady supply, and possible infectious disease transmission. Here, we review the literature on bioprinting strategies, 3D corneal modelling, material options, and cellularization strategies in relation to keratoprosthesis design. The progress, limitations and expectations of recent cases of 3D bioprinting of artifial cornea are discussed. An outlook on the rise of 3D bioprinting in corneal reconstruction and regeneration is provided.
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Affiliation(s)
- Shuo Jia
- Department of Ophthalmology, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yashan Bu
- Department of Ophthalmology, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Dzi-Shing Aaron Lau
- Department of Orthopedic and Traumatology, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Zhizhen Lin
- Department of Ophthalmology, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Tianhao Sun
- Department of Orthopedic and Traumatology, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong SAR, China,Shenzhen Gangqing Biomedical Technology Co. Ltd, Shenzhen, China
| | - Weijia William Lu
- Department of Orthopedic and Traumatology, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong SAR, China,Research Center for Human Tissues and Organs Degeneration, Institute of Biomedicine and Biotechnology, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Sheng Lu
- Department of Orthopedic Surgery, The First People’s Hospital of Yunnan Province, Kunming, China
| | - Changshun Ruan
- Research Center for Human Tissues and Organs Degeneration, Institute of Biomedicine and Biotechnology, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Cheuk-Hung Jonathan Chan
- Department of Ophthalmology, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, Hong Kong SAR, China,*Correspondence: Cheuk-Hung Jonathan Chan,
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Charnock LN, Boveland SD, Groover ES, Moore PA, McMullen RJ. Effects of corneoconjunctival transposition, posterior lamellar keratoplasty and modified deep lamellar endothelial keratoplasty on streak retinoscopy in equine cadaver eyes. Vet Ophthalmol 2022; 25:483-492. [PMID: 36121370 DOI: 10.1111/vop.13025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 09/06/2022] [Accepted: 09/08/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Evaluate the effects of corneoconjunctival transposition (CCT), posterior lamellar keratoplasty (PLK) and modified deep lamellar endothelial keratoplasty (DLEK) on streak retinoscopy in equine cadaver eyes. METHODS Intraocular pressure (IOP) was maintained at 25 ± 3 mmHg in 35 equine cadaver eyes. Streak retinoscopy was performed prior to (NO VISCO) and following (VISCO) intracameral injection of 1.0 ml of viscoelastic. Following optical coherence tomography (OCT), an axial CCT [n = 11] or PLK [n = 12], or peripheral DLEK [n = 12] was performed. Streak retinoscopy and OCT were repeated postoperatively. RESULTS Postsurgical net meridional and spherical refraction for CCT [Horizontal (H): 3.4 (95% CI 2.4-4.4) diopters (D), p < .001, Vertical (V): 3.5 (95% CI 2.7-4.4) D, p < .001, Spherical: 3.5 (95% CI 2.6-4.3) D, p < .001] and PLK [H: 3.2 (95% CI 2.2-4.1) D, p < .001, V: 2.8 (95% CI 2.0-3.6) D, p < .001, Spherical: 3.0 (95% CI 2.2-3.8) D, p < .001] were significantly increased from presurgical (VISCO) values. No difference between presurgical (VISCO) and postsurgical values were identified for the DLEK. Postoperative OCT revealed space between anterior and posterior corneal grafts and corneal undulation associated with suture placement. CONCLUSION Meridional and spherical refraction had a hyperopic shift following CCT and PLK, with a significantly higher value in the vertical meridian for the CCT. Pre- and postoperative refraction was not significantly different for the DLEK. This supports that the DLEK has a lesser effect on immediate postoperative refraction compared with CCT or PLK.
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Affiliation(s)
- Lauren N Charnock
- College of Veterinary Medicine, Auburn University, Auburn, Alabama, USA
| | | | - Erin S Groover
- College of Veterinary Medicine, Auburn University, Auburn, Alabama, USA
| | - Phillip A Moore
- College of Veterinary Medicine, Auburn University, Auburn, Alabama, USA
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Cognard S, Barnouin L, Bosc J, Gindraux F, Robin MC, Douet JY, Thuret G. New Devitalized Freeze-Dried Human Umbilical Cord Amniotic Membrane as an Innovative Treatment of Ocular Surface Defects: Preclinical Results. J Funct Biomater 2022; 13:jfb13030150. [PMID: 36135586 PMCID: PMC9502562 DOI: 10.3390/jfb13030150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 08/26/2022] [Accepted: 09/08/2022] [Indexed: 12/03/2022] Open
Abstract
A preclinical study was performed to investigate the efficacy and safety of a new viral inactivated, devitalized, freeze-dried and gamma-sterilized human umbilical cord amniotic membrane (lhUC-AM) for the treatment of deep scleral and corneal defects with or without perforation. Firstly, lhUC-AM was investigated on experimental deep sclerectomy in rabbit eyes (n = 12) and compared to autograft (n = 4) on cross section histology. Secondly, lhUC-AM was studied on a selected series of uncontrolled cases of corneal defects (n = 18) with or without perforation, in dogs and cats. lhUC-AM tolerance, reconstruction of the deep corneal lesion and recovery of the structural aspect of the tissue were followed post-surgery. In experimental deep sclerectomy, histology showed that the lhUC-AM was well tolerated and degraded completely in 45 days while allowing an overall quality and kinetic of scleral regeneration, similar to autograft. In the clinical situations, lhUC-AM was well tolerated, with ocular inflammatory signs quickly decreasing after surgery. Mean follow-up was 16.40 ± 11.43 months. In 15 out of 18 cases, lhUC-AM allowed ocular surface wound healing. The ocular surface was fully reconstructed three months after surgery. This study suggests a good safety and efficacy profile of lhUC-AM in the treatment of deep corneal or scleral defect in animals. This new tissue should now facilitate the treatment of severe ocular surface diseases in humans.
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Affiliation(s)
- Sophie Cognard
- Clinique Vétérinaire des Ducs de Bourgogne, 11 Ter Rue Paul Langevin, 21300 Chenove, France
| | - Laurence Barnouin
- Tissue Bank of France, 6 rue d’Italie, 69780 Mions, France
- Correspondence: ; Tel.: +33-4-72-68-69-09
| | - Justine Bosc
- Tissue Bank of France, 6 rue d’Italie, 69780 Mions, France
| | - Florelle Gindraux
- Service de Chirurgie Orthopédique, Traumatologique et Plastique, CHU Besançon, F-25000 Besançon, France
- Laboratoire de Nanomédecine, Imagerie, Thérapeutique EA 4662, Université Bourgogne Franche-Comté, F-25000 Besançon, France
| | - Marie-Claire Robin
- Small Animal Clinic, Université de Toulouse, ENVT, 31300 Toulouse, France
| | - Jean-Yves Douet
- Small Animal Clinic, Université de Toulouse, ENVT, 31300 Toulouse, France
- IHAP, Université de Toulouse, INRAE, ENVT, 31300 Toulouse, France
| | - Gilles Thuret
- Biology, Engineering and IMAGING of Corneal Graft, BiiGC, Faculty of Medicine, Health Innovation Campus, 10 rue de la Marandière, 42270 Saint-Priest en Jarez, France
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Telle MR, Betbeze C. Corneal Surgery in the Cat: Diseases, considerations and techniques. J Feline Med Surg 2022; 24:429-441. [PMID: 34844459 PMCID: PMC11104038 DOI: 10.1177/1098612x211061049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PRACTICAL RELEVANCE The ability to recognize, diagnose and treat corneal disease is essential for maintaining vision and comfort in feline patients. Being able to correctly identify appropriate techniques for surgical cases is of particular importance for success when performing corneal surgery. CLINICAL CHALLENGES Many different corneal diseases present with similar clinical signs, and it can be hard to determine the appropriate treatment for individual patients. It is essential for the clinician to understand the indications for corneal surgery, instrumentation needed and microsurgical principles prior to attempting these procedures. The prognosis following surgery and potential complications should be discussed with the client. AUDIENCE This review article aims to assist in decision-making and to provide detailed guidance for primary care clinicians considering referral of cats for corneal surgery. The review outlines common feline corneal diseases and associated surgical therapies performed by veterinary ophthalmologists, highlighting appropriate instrumentation and case selection. Some surgeries are explained in depth for ophthalmologists and residents in training. EQUIPMENT Although some procedures may be performed with common surgical equipment and supplies, most require specialized ophthalmic instrumentation and expertise, which entails significant microsurgical training and practice, as well as financial investment. Most of the procedures require an operating microscope for the best surgical outcomes; however, surgical loupes may be sufficient in some cases. Evidence base: This review article compiles information from many published references on feline corneal diseases and surgeries, complemented by the experience of the authors.
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Affiliation(s)
- Mary Rebecca Telle
- Mississippi State University College of Veterinary Medicine, 240 Wise Center Drive, PO Box 6100, MS 39762, USA
| | - Caroline Betbeze
- Mississippi State University College of Veterinary Medicine, 240 Wise Center Drive, PO Box 6100, MS 39762, USA
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Torsahakul C, Israsena N, Khramchantuk S, Ratanavaraporn J, Dhitavat S, Rodprasert W, Nantavisai S, Sawangmake C. Bio-fabrication of stem-cell-incorporated corneal epithelial and stromal equivalents from silk fibroin and gelatin-based biomaterial for canine corneal regeneration. PLoS One 2022; 17:e0263141. [PMID: 35120168 PMCID: PMC8815981 DOI: 10.1371/journal.pone.0263141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 01/12/2022] [Indexed: 01/15/2023] Open
Abstract
Corneal grafts are the imperative clinical treatment for canine corneal blindness. To serve the growing demand, this study aimed to generate tissue-engineered canine cornea in part of the corneal epithelium and underlying stroma based on canine limbal epithelial stem cells (cLESCs) seeded silk fibroin/gelatin (SF/G) film and canine corneal stromal stem cells (cCSSCs) seeded SF/G scaffold, respectively. Both cell types were successfully isolated by collagenase I. SF/G corneal films and stromal scaffolds served as the prospective substrates for cLESCs and cCSSCs by promoting cell adhesion, cell viability, and cell proliferation. The results revealed the upregulation of tumor protein P63 (P63) and ATP-binding cassette super-family G member 2 (Abcg2) of cLESCs as well as Keratocan (Kera), Lumican (Lum), aldehyde dehydrogenase 3 family member A1 (Aldh3a1) and Aquaporin 1 (Aqp1) of differentiated keratocytes. Moreover, immunohistochemistry illustrated the positive staining of tumor protein P63 (P63), aldehyde dehydrogenase 3 family member A1 (Aldh3a1), lumican (Lum) and collagen I (Col-I), which are considerable for native cornea. This study manifested a feasible platform to construct tissue-engineered canine cornea for functional grafts and positively contributed to the body of knowledge related to canine corneal stem cells.
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Affiliation(s)
- Chutirat Torsahakul
- Graduate program in Veterinary Bioscience, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
- Veterinary Stem Cell and Bioengineering Research Unit, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
- Veterinary Stem Cell and Bioengineering Innovation Center (VSCBIC), Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Nipan Israsena
- Stem Cell and Cell Therapy Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Department of Pharmacology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Supaporn Khramchantuk
- Excellence Center for Stem Cell and Cell Therapy, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
| | - Juthamas Ratanavaraporn
- Biomedical Engineering Program, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand
- Biomedical Engineering Research Center, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand
- Biomedical Engineering for Medical and Health Research Unit, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand
| | - Sirakarnt Dhitavat
- Biochemistry Unit, Department of Physiology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Watchareewan Rodprasert
- Veterinary Stem Cell and Bioengineering Research Unit, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
- Veterinary Stem Cell and Bioengineering Innovation Center (VSCBIC), Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Sirirat Nantavisai
- Veterinary Stem Cell and Bioengineering Research Unit, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
- Veterinary Stem Cell and Bioengineering Innovation Center (VSCBIC), Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
- Academic Affairs, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Chenphop Sawangmake
- Veterinary Stem Cell and Bioengineering Research Unit, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
- Veterinary Stem Cell and Bioengineering Innovation Center (VSCBIC), Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
- Department of Pharmacology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence for Regenerative Dentistry (CERD), Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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Prando F, Pereira J, Medeiros R, Balthazar D. Use of automated central lamellar superficial keratectomy in the treatment of chronic pigmentary superficial keratitis in dogs. ARQ BRAS MED VET ZOO 2022. [DOI: 10.1590/1678-4162-12224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Pigmentary superficial keratitis (PSK) is a chronic corneal disorder with different causes, which may include immune-mediated diseases and reactions to ultraviolet rays. This study aimed to evaluate the use of automated central lamellar superficial keratectomy (ACLSK) in the treatment of chronic pigmentary superficial keratitis (CPSK) in dogs. We enrolled 24 animals with CPSK and loss of visual function even after clinical treatment with preserved post-corneal transparent media, and the potential for recovery of visual function after surgical treatment. The microkeratome was positioned on the eye surface, and the central corneal lamellae were obtained after translation. With ACSLC, 21 animals (87.5%) recovered their visual function. In 3 animals (12.5%), the formation of granuloma and posterior central leukoma in the cornea compromised the transparency of the visual axis. This study concludes that ACLSK is a viable surgical alternative for the restoration of visual function in dogs with severe PSK, thus improving their quality of life. The short execution time of this procedure reduces the costs and anesthetic risks.
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Affiliation(s)
- F.A.S. Prando
- Universidade Federal Rural do Rio de Janeiro, Brazil; Centro de Estudos, Pesquisa e Oftalmologia Veterinária, Brasil
| | - J.S. Pereira
- Centro de Estudos, Pesquisa e Oftalmologia Veterinária, Brasil
| | - R.S. Medeiros
- Centro de Estudos, Pesquisa e Oftalmologia Veterinária, Brasil
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Mezzadri V, Crotti A, Nardi S, Barsotti G. Surgical treatment of canine and feline descemetoceles, deep and perforated corneal ulcers with autologous buccal mucous membrane grafts. Vet Ophthalmol 2021; 24:599-609. [PMID: 34085742 PMCID: PMC9292918 DOI: 10.1111/vop.12907] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 03/03/2021] [Accepted: 05/15/2021] [Indexed: 12/01/2022]
Abstract
Objectives To report the surgical technique and postoperative outcome of corneal repair with autologous buccal mucous membrane grafts in dogs and cats with descemetoceles, deep corneal ulcers, and perforated corneal ulcers with or without iris prolapse. Animal studied Twelve cats (13 eyes) and fourteen dogs (14 eyes) were treated. Procedures Grafts were harvested from the unpigmented superior labial mucosa using a biopsy punch. The corneal lesion was carefully debrided and cleaned. The graft was secured to the healthy cornea with a combination of simple interrupted and continuous 9–0 polyglycolic acid sutures. In 25/27 treated eyes, an overlying pedicle conjunctival graft was also performed. A temporary nictitating membrane flap was used in all cases. The pedicle conjunctival graft was trimmed about 10–20 days postoperatively. The median follow‐up period was 549.2 days (range 14–2691 days). Results No surgical intra‐operative complications were observed. The ulcers healed and the integrity of the globe was restored in 24/27 treated eyes. Different grades of corneal fibrosis and/or vascularization and/or pigmentation were observed in all cases at the long‐term follow‐up. In two cases, enucleation was performed due to postoperative complications and one animal developed phthisis bulbi. A total of 22/27 treated eyes appeared to have regained effective visual function at the last clinical evaluation. Conclusions Autologous buccal mucous membrane grafts appear to successfully manage severe corneal ulcers in dogs and cats, providing a useful and economical alternative to other corneal grafts.
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Affiliation(s)
- Valentina Mezzadri
- Oculistica Veterinaria Genova, Genova, Italy.,Department of Veterinary Science, University of Pisa, Pisa, Italy
| | | | - Samanta Nardi
- Department of Veterinary Science, University of Pisa, Pisa, Italy
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Jaksz M, Fischer MC, Fenollosa-Romero E, Busse C. Autologous corneal graft for the treatment of deep corneal defects in dogs: 15 cases (2014-2017). J Small Anim Pract 2020; 62:123-130. [PMID: 33258490 DOI: 10.1111/jsap.13262] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/27/2020] [Accepted: 10/14/2020] [Indexed: 01/26/2023]
Abstract
OBJECTIVES To describe the use of corneal autografts for repair of deep corneal defects in dogs. MATERIALS AND METHODS Retrospective analysis of clinical records of dogs that received autologous corneal grafts. RESULTS Fifteen dogs (16 eyes) of different breed, age and gender were included. Brachycephalic breeds were overrepresented (10/15 dogs). Defects were unilateral in 14 dogs and bilateral in one dog, extended to at least 80% of the stromal thickness in all eyes, with descemetoceles in four eyes and corneal perforations in five eyes. Most ulcers (13/16 eyes) were located centrally. Corneal autografts were harvested from healthy peripheral cornea of the ipsilateral eye. The thickness of the autograft was limited to a set depth of 0.3 mm. The autograft was sutured into a previously debrided ulcer bed with a continuous or simple interrupted suture pattern using absorbable or non-absorbable suture material. Additional interventions included a partial temporary tarsorrhaphy and bandage contact lenses. Postoperatively patients received topical antibiotics and systemic anti-inflammatory drugs, and 12/15 dogs also received systemic antibiotics. Mean follow-up time was 54 days (2 to 462). In all eyes the donor site healed uneventfully with mild, persistent corneal fibrosis. Postoperative complications included autograft keratomalacia, graft dehiscence and corneal pigmentation. No patient required additional surgery. Good structural and functional outcome was accomplished in 14 of 16 eyes. CLINICAL SIGNIFICANCE Autologous corneal grafts provide tectonic support and result in good corneal transparency in selected cases of dogs with deep to perforated corneal ulcerations.
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Affiliation(s)
- M Jaksz
- Dick White Referrals, Station Farm, London Road, Six Mile Bottom, Suffolk, CB8 0UH, UK
| | - M-C Fischer
- Dick White Referrals, Station Farm, London Road, Six Mile Bottom, Suffolk, CB8 0UH, UK
| | - E Fenollosa-Romero
- Dick White Referrals, Station Farm, London Road, Six Mile Bottom, Suffolk, CB8 0UH, UK
| | - C Busse
- Dick White Referrals, Station Farm, London Road, Six Mile Bottom, Suffolk, CB8 0UH, UK
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Thajunnisa AS, Sainulabdeen A, Dileepkumar KM, Philip LM, Vasudevan VN, Devanand CB. Comparative evaluation of decellularized bovine omentum alone and in combination with mitomycin-C in the management of corneal injuries in dogs. Vet World 2020; 13:2401-2410. [PMID: 33363333 PMCID: PMC7750223 DOI: 10.14202/vetworld.2020.2401-2410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 10/07/2020] [Indexed: 11/20/2022] Open
Abstract
Background and Aim: Ulcerative corneal lesions are common ocular affections encountered in veterinary ophthalmology, having a higher incidence in dogs with brachycephalic conformation. Prompt and effective diagnosis and repair are necessary to avoid corneal perforation and restore vision. Corneal wound healing is a complex phenomenon often resulting in vision impairment as a consequence of corneal fibrosis and pigmentation. The present study investigated the efficacy of decellularized and gamma-irradiated bovine omentum as an extracellular matrix scaffold in the reconstruction of extensive and full-thickness corneal defects, and the cytotoxic effects of mitomycin-C (MMC) to prevent corneal fibrosis and pigmentation. Materials and Methods: Twelve injured corneas of eleven dogs irrespective of breed, age, and sex were randomly divided into Groups I and II, consisting of six corneas each. Under general anesthesia, corneal grafting with decellularized and gamma-irradiated bovine omentum was carried out in Group I, whereas Group II corneas underwent single time intra-operative application of topical MMC for 2 min before corneal grafting with the same material. Epithelialization of cornea and observations including corneal edema, neovascularization, the extent of pigmentation, corneal clarity, and scarring was recorded on days 7, 14, 21, and 60 postoperatively. Results: All corneas in Group I showed early epithelialization by day 7 compared to Group II where the MMC delayed epithelialization in 50% of the corneas. Visual function scores improved greatly from 0.17±0.17 in Group II on the day of presentation to 1.0±00 by the end of the observation period compared to Group I (from 0.33±0.15 to 0.88±0.11). Although epithelialization and corneal healing were delayed, 50% of the corneas recovered with undetectable corneal scar and melanosis at the end of the observation period in Group II due to the anti-fibrotic effect of MMC. Conclusion: From the present study, it was concluded that re-epithelialization of the cornea was enhanced by corneal grafting with decellularized bovine omentum, and application of MMC was effective in delaying corneal fibrosis and pigmentation.
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Affiliation(s)
- A S Thajunnisa
- Department of Veterinary Surgery and Radiology, College of Veterinary and Animal Sciences, Kerala Veterinary and Animal Sciences University, Mannuthy, Kerala, India
| | - Anoop Sainulabdeen
- Department of Veterinary Surgery and Radiology, College of Veterinary and Animal Sciences, Kerala Veterinary and Animal Sciences University, Mannuthy, Kerala, India
| | - K M Dileepkumar
- Department of Veterinary Surgery and Radiology, College of Veterinary and Animal Sciences, Kerala Veterinary and Animal Sciences University, Mannuthy, Kerala, India
| | - Laiju M Philip
- Department of Veterinary Surgery and Radiology, College of Veterinary and Animal Sciences, Kerala Veterinary and Animal Sciences University, Mannuthy, Kerala, India
| | - V N Vasudevan
- Department of Livestock Products Technology, College of Veterinary and Animal Sciences, Kerala Veterinary and Animal Sciences University, Mannuthy, Kerala, India
| | - C B Devanand
- Department of Veterinary Surgery and Radiology, College of Veterinary and Animal Sciences, Kerala Veterinary and Animal Sciences University, Mannuthy, Kerala, India
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Cebrian P, Escanilla N, Lowe RC, Dawson C, Sanchez RF. Corneo-limbo-conjunctival transposition to treat deep and perforating corneal ulcers in dogs: A review of 418 eyes and corneal clarity scoring in 111 eyes. Vet Ophthalmol 2020; 24:48-58. [PMID: 33034144 DOI: 10.1111/vop.12833] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 09/17/2020] [Accepted: 09/18/2020] [Indexed: 01/19/2023]
Abstract
PURPOSE To report surgical and corneal clarity scores (CCSs) of corneo-limbo-conjunctival transpositions (CLCTs) in a large number of canine cases. METHODS Retrospective review of records that underwent CLCT to repair deep ulcers or perforations between 2002 and 2018. Signalment, concurrent eye disease, additional procedures, pathogenesis, medication, graft orientation, follow-up, and CCSs were recorded. RESULTS 418 eyes of 399 dogs were included. Brachycephalics were most commonly affected, comprising 325/418 (77.75%) of the eyes. The most commonly affected breeds were Pugs, Shih Tzus, Cavalier King Charles Spaniels, and French Bulldogs, with 116/418 (27.75%), 64/418 (15.31%), 34/418 (8.13%), and 34/418 (8.13%) ulcerated eyes, respectively. Mean age at surgery was 5.5 years (range 59 days-17.7 years), and median follow-up time was 100 days (range 3 days-7.64 years). The most common etiopathogenesis was spontaneous ulceration in 205/418 eyes (49.04%) of which 191 (93.17%) occurred in brachycephalics. Primary keratoconjunctivitis sicca affected 122/418 eyes (29.19%) and injury 39/418 eyes (9.33%). Mean ulcer width was 3.5 mm (0.5-10 mm). Success rate was 97.13% (406/418 eyes). Failure end points recorded included no menace response, secondary glaucoma, and endophthalmitis. Pre-existing perforation was found in 101/418 (24.16%) of the eyes and significantly increased failure rate (P < .001). The median CCS was G3 (G0-G4), which was lower for Pugs (G2). Graft orientation affected CCS, but did not reach statistical significance. CONCLUSION The high success rate and CCS for CLCT in dogs make it a good technique to treat deep ulcers but a less desirable outcome is anticipated when treating perforations and Pugs.
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Affiliation(s)
| | | | | | | | - Rick F Sanchez
- Specialistische Dierenkliniek (Anicura) Utrecht, Utrecht, Netherlands
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14
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Keenan AV, Boveland SD, Rodriguez Galarza R, Moore PA. Corneoconjunctival transposition with and without ACell ® for deep corneal ulcer repair in 18 dogs. Vet Ophthalmol 2020; 23:884-891. [PMID: 32790061 DOI: 10.1111/vop.12815] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 06/07/2020] [Accepted: 07/28/2020] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To document a case series using corneoconjunctival transposition (CCT) surgery with and without bioscaffolding matrix (ACell® ) to repair deep corneal ulcers and perforations in dogs. ANIMALS STUDIED Eighteen dogs of various breeds that presented with deep or perforating corneal ulcers. PROCEDURES Corneoconjunctival transposition grafts with or without ACell® were sutured using a simple interrupted 8-0 or 9-0 polyglactin 910 pattern. RESULTS A total of eighteen dogs (19 eyes) were diagnosed with deep corneal ulcers (n = 7) and perforating corneal ulcers (n = 12). A CCT was performed in all eyes, with ten of them additionally receiving an ACell® graft. The majority of lesions were located axially in 14/19 (81%) eyes. Grafts were harvested from dorsal (n = 8), temporal (n = 5), ventral (n = 4), or nasal (n = 2) quadrants. Brachycephalic breeds (13/18) were over-represented. Keratoconjunctivitis sicca was present in 10/19 eyes (52.6%). Bacterial isolates were cultured from 8/19 eyes. Post-operative therapy included topical antibiotics, plasma, cycloplegics, oral antibiotics, and oral nonsteroidal anti-inflammatory drugs. CCT integration with and without ACell® occurred at a median of 20 days (range 7-38 days) post-operatively with no significant difference between groups. Median follow-up time was 188 days. Short-term post-operative complications included granulation tissue formation (19/19), corneal edema (4/19), graft retraction (4/19), and anterior synechia (1/19). Long-term complications in 14 eyes with follow-up >30 days included superficial corneal pigmentation (6/14) and epithelial inclusion cysts (5/14). Two eyes were nonvisual at last follow-up due to cataract formation. CONCLUSIONS Corneoconjunctival transposition with ACell® can be utilized for corneal ulcer repair in dogs.
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Affiliation(s)
- Alessandra V Keenan
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | - Shannon D Boveland
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | | | - Phillip A Moore
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
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Gogova S, Leiva M, Ortillés Á, Lacerda RP, Seruca C, Laguna F, Crasta M, Ríos J, Peña MT. Corneoconjunctival transposition for the treatment of deep stromal to full-thickness corneal defects in dogs: A multicentric retrospective study of 100 cases (2012-2018). Vet Ophthalmol 2020; 23:450-459. [PMID: 31950569 DOI: 10.1111/vop.12740] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 11/22/2019] [Accepted: 12/20/2019] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To describe and evaluate the use of corneoconjunctival transposition (CTT) as a surgical treatment for canine deep stromal ulcers, descemetoceles, and full-thickness corneal defects and to determine its efficacy in preserving corneal graft transparency and vision. ANIMALS STUDIED One hundred client-owned dogs with deep stromal ulcers, descemetoceles, or full-thickness corneal defects. METHODS Medical records of canine patients that underwent CCT, from 2012 to 2018, were reviewed. Only, patients with preoperative positive consensual pupillary light and dazzle reflexes were included. RESULTS There were 59 males and 41 females, from 0.3 to 17 years. Brachycephalic breeds were overrepresented (65%). All patients were unilaterally affected, with 16 deep stromal ulcers, 33 descemetoceles, and 51 corneal perforations, of a median (range) size of 4 (2-8) mm. The central cornea was affected in the majority of cases (57%), and euryblepharon and keratoconjunctivitis sicca were the most common concurrent ocular diseases (42% and 40%, respectively). The graft was most frequently harvested from dorsal (67%), and 9/0 absorbable suture material was used. Intraoperative and postoperative complications were seen in 7 and 21 cases, respectively. Mean follow-up time was 107.8 days. Vision was preserved in 96% patients, with 62% showing faint to mild opacification. Among the statistically analyzed variables, euryblepharon and pigmentary keratitis were found to be significantly associated with greater corneal graft opacification (P = .040 and P = .028, respectively). CONCLUSIONS Corneoconjunctival transposition is an effective surgical treatment for deep stromal, descemetocele, and full-thickness corneal defects in dogs, achieving a highly satisfactory degree of corneal graft transparency and preserving vision.
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Affiliation(s)
- Savina Gogova
- Fundació Hospital Clínic Veterinari, Campus Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Marta Leiva
- Fundació Hospital Clínic Veterinari, Campus Universitat Autònoma de Barcelona, Bellaterra, Spain.,Departament de Medicina i Cirurgia Animal, Facultat de Veterinaria, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Ángel Ortillés
- Fundació Hospital Clínic Veterinari, Campus Universitat Autònoma de Barcelona, Bellaterra, Spain
| | | | | | | | | | - Jose Ríos
- Laboratory of Biostatistics & Epidemiology, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Maria Teresa Peña
- Fundació Hospital Clínic Veterinari, Campus Universitat Autònoma de Barcelona, Bellaterra, Spain.,Departament de Medicina i Cirurgia Animal, Facultat de Veterinaria, Universitat Autònoma de Barcelona, Bellaterra, Spain
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Barachetti L, Zanni M, Stefanello D, Rampazzo A. Use of four-layer porcine small intestinal submucosa alone as a scaffold for the treatment of deep corneal defects in dogs and cats: preliminary results. Vet Rec 2020; 186:e28. [PMID: 31937546 DOI: 10.1136/vr.105513] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 10/20/2019] [Accepted: 12/05/2019] [Indexed: 01/18/2023]
Abstract
BACKGROUND To describe the efficacy of four-layer porcine small intestinal submucosa (Vetrix BioSIS plus+) as single scaffold for the treatment of deep corneal lesions in dogs and cats. METHODS 10 dogs and 3 cats with deep or full thickness corneal defects were treated surgically with BioSIS plus graft. Corneal transparency scores and vision were evaluated. RESULTS Lesions in dogs were four perforations, three descemetoceles, two limbal melanocytomas and one deep corneal ulcer. In cats, there were one limbal melanocytoma and two perforations. The average length of the follow-up was 86 days. In all, 12 out of 13 eyes treated were visual at last recheck (92.3 per cent). The scars were mild eight cases (66.7 per cent), but denser in four cases (33.4 per cent). Complication were partial collagenolysis in three cases (25 per cent), which resolved with medical therapy, mild corneal pigmentation in one case (8.4 per cent) and anterior synechia in one case (8.4 per cent). One case experienced severe collagenolysis and was enucleated 21 days postoperatively. CONCLUSIONS Four-layer porcine SIS graft was successfully used for surgical treatment of deep corneal lesions in selected corneal diseases in a small series of dogs and cats, with good results in terms of mechanic support and corneal transparency.
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Affiliation(s)
- Laura Barachetti
- Department of Veterinary Medicine, University of Milan, Milan, Italy .,Dipartimento di Oftalmologia, Istituto Veterinario di Novara, Granozzo con Monticello, Italy
| | - Marco Zanni
- Department of Veterinary Science and Public Health, University of Milan, Milan, Italy
| | | | - Antonella Rampazzo
- Equine Department, Universitat Zurich Vetsuisse-Fakultat, Zurich, Switzerland
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Duman R, Ertekin T, Duman R, Aslan E, Sabaner MC, Cetinkaya E. The novel model: Experimental optical coherence tomography-guided anterior segment imaging chick embryo model. Indian J Ophthalmol 2018; 67:54-58. [PMID: 30574893 PMCID: PMC6324092 DOI: 10.4103/ijo.ijo_263_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose The aim of this study was to present an experimental optical coherence tomography (OCT)-guided anterior segment (AS) imaging chick embryo model. Through this model, we aimed to reveal similarities and differences between human cornea, AS tissues, and chick embryo tissues by quantitative image analysis. Methods Ex vivo, the chick embryos' globes were determined by detailed AS camera of spectral-domain (SD)-OCT in 10 fertilized specific pathogen-free eggs on the 20th day. Quantitative image analysis of anterior chamber tissues was performed with SD-OCT in detail. After imaging, cross sections of the chick embryo globes containing cornea with anterior chamber were histologically examined and compared with human tissues. The similarities of our model with data in the human cornea and AS studies in the literature were compared. Results SD-OCT imaging was able to successfully delineate the AS tissues of chick embryos such as the cornea, iris, lens, pupil, conjunctiva, ciliary body, anterior chamber, and lens. Quantitative semi-automated measurements showed the following: mean central corneal thickness: 213.4 ± 7.05 μm (197-223 μm), mean anterior chamber depth: 878.9 ± 41.74 (804-919 μm), mean anterior chamber area: 2.43 ± 0.16 mm2 (2.17-2.73 mm2), mean corneoscleral junction (limbal) thickness: 322.8 ± 20.05 μm (289-360 μm), and mean iris thickness: 230.4 ± 13.27 μm (203-245 μm). In addition, detailed histological comparisons of the AS tissues with human tissues were evaluated to be very similar. Conclusion In conclusion, this chick embryo model mimics human tissues and it can be considered as a platform for the study of teratogen-induced malformations and AS dysgenesis during gestation of AS tissues. In addition, this study demonstrates the feasibility of SD-OCT in the quantitative assessment of AS structures in chick embryo model.
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Affiliation(s)
- Resat Duman
- Department of Ophthalmology, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Tolga Ertekin
- Department of Anatomy, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Rahmi Duman
- Department of Ophthalmology, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Esra Aslan
- Department of Histology-Embryology, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Mehmet Cem Sabaner
- Department of Ophthalmology, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Ersan Cetinkaya
- Department of Ophthalmology, Antalya Education and Research Hospital, Antalya, Turkey
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Graham KL, White JD, Billson FM. Feline corneal sequestra: outcome of corneoconjunctival transposition in 97 cats (109 eyes). J Feline Med Surg 2017; 19:710-716. [PMID: 27107040 PMCID: PMC11128799 DOI: 10.1177/1098612x16645144] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Case series summary A retrospective study was undertaken to review outcomes of keratectomy and corneoconjunctival transposition in cats with superficial and deep corneal sequestra. Information including pertinent history, signalment, ophthalmological findings and postoperative outcome was collected from medical records. Follow-up was obtained by clinical examination, contact with the referring veterinarians and review of medical records or telephone contact with owners. Ninety-seven cats (109 eyes) were included from 2005-2015. The most commonly affected breeds included Persian, Burmese and Himalayan. The mean age at the time of surgery was 6.8 years (median 6.5 years; range 8.0 months-18.0 years). A corneal sequestrum in the contralateral eye was diagnosed in 28 cats (28.9%). Recurrent corneal sequestration was diagnosed in eight cats (nine eyes), with recurrence occurring a mean of 703 days after surgery (range 29-1750 days). Age, sex, breed, depth of sequestration and concurrent ocular disease in the contralateral eye were compared between cats with and without recurrence, with no risk factors for recurrence identified. Relevance and novel information Excellent surgical outcomes have previously been described in a series of 17 cats with superficial and mid-stromal corneal sequestra. This paper adds further information to the literature by describing a larger series of cats, with corneal sequestra affecting the full range of corneal thickness, and good long-term postoperative outcomes.
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Affiliation(s)
- Kathleen L Graham
- Ophthalmology Department, Small Animal Specialist Hospital, North Ryde, Australia
| | - Joanna D White
- Internal Medicine Department, Small Animal Specialist Hospital, North Ryde, Australia
| | - Francis M Billson
- Ophthalmology Department, Small Animal Specialist Hospital, North Ryde, Australia
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Evaluation of stability and biocompatibility of PHEMA-PMMA keratoprosthesis by penetrating keratoplasty in rabbits. Lab Anim Res 2016; 32:181-186. [PMID: 28053610 PMCID: PMC5206223 DOI: 10.5625/lar.2016.32.4.181] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 09/23/2016] [Accepted: 11/14/2016] [Indexed: 11/21/2022] Open
Abstract
Artificial corneas have been developed as an alternative to natural donor tissue to replace damaged or diseased corneas. This study was conducted to evaluate the stability and biocompatibility of PHEMA-PMMA [poly (2-hydroxyl methacrylate)-poly (methyl methacrylate)] keratoprostheses in rabbits following penetrating keratoplasty. Sixteen male New Zealand White rabbits aged 16 weeks were divided into three groups. Group I and group II contained six rabbits each, while the control group had four rabbits. Experimental surgery was conducted under general anesthesia. The cornea was penetrated using an 8 mm diameter biopsy punch. In group I (core 5 mm & skirt 3 mm) and group II (core 6 mm & skirt 2 mm), the keratoprosthesis was placed into the recipient full thickness bed and sutured into position with double-layer continuous. In the control group, corneal transplantation using normal allogenic corneal tissue was performed with the same suture method. After four and eight weeks, keratoprosthesis devices were evaluated by histopathological analysis of gross lesions. Post-operative complications were observed, such as extrusion and infection in experimental groups. Most corneas were maintained in the defect site by double-layer continuous suture materials for 4 weeks and kept good light transmission. However, most artificial cornea were extruded before 8 weeks. Overall, combined PHEMA and PMMA appears to have sufficient advantages for production of artificial corneas because of its optical transparency, flexibility and other mechanical features. However, the stability and biocompatibility were not sufficient to enable application in humans and animals at the present time using penetrating keratoplasty. Further studies are essential to improve the stability and biocompatibility with or without other types of keratoplasty.
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O'Neill DG, Darwent EC, Church DB, Brodbelt DC. Demography and health of Pugs under primary veterinary care in England. Canine Genet Epidemiol 2016; 3:5. [PMID: 27293771 PMCID: PMC4903005 DOI: 10.1186/s40575-016-0035-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 06/03/2016] [Indexed: 01/28/2023] Open
Abstract
Background The Pug is an ancient dog breed and was the fifth most commonly registered UK pedigree breed in 2014. However, the breed has been reported to be predisposed to several disorders including ocular, respiratory and dermatological problems. The VetCompass Programme collates de-identified clinical data from primary-care veterinary practices in the UK for epidemiological research. Using VetCompass clinical data, this study aimed to characterise the demography and common disorders of the general population of Pugs under veterinary care in England. Results Pugs comprised 2709 (1.03 %) of 264,260 study dogs under veterinary care from September 1st, 2009 to 30th April, 2015. Annual proportional birth rates showed that Pugs rose from less than 1 % of annual birth cohorts before 2008 to comprise 2.8 % of the 2013 annual birth cohort. The most common colours of Pugs were fawn (63.1 %), black (27.7 %), apricot (7.6 %) and silver (2.1 %). Of the 1009 pugs under veterinary care in the study during 2013, 688 (68.19 %) had at least one disorder recorded. The most prevalent disorders recorded overall were overweight/obesity (number of events: 133, prevalence: 13.18 %, 95 % CI: 11.12–15.43), corneal disorder (88, 8.72 %, 95 % CI: 7.05–10.63) and otitis externa (76, 7.53 %, 95 % CI: 5.98–9.34). The most prevalent disorder groups were ophthalmological (n = 164, prevalence: 16.25 %, 95 % CI: 14.03–18.68), dermatological (157, 15.60 %, 95 % CI: 13.38–17.95) and aural (152, 15.06 %, 95 % CI: 12.91–17.42). The most prevalent body locations affected were the head-and-neck (n = 439, prevalence = 43.51 %, 95 % CI: 40.42–46.63) and abdomen (195, 19.33 %, 95 % CI: 16.93–21.90). The most prevalent organ systems affected were the integument (321, 31.81 %, 95 % CI: 28.15–35.72) and digestive (257, 25.47 %, 95 % CI: 22.54–28.65). The most prevalent pathophysiologic processes recorded were inflammation (386, 38.26 %, 95 % CI: 34.39–42.27) and congenital/developmental (153, 15.16 %, 95 % CI: 12.61–18.13). Conclusions Ownership of Pugs in England is rising steeply. Overweight/obesity, corneal disorder and otitis externa are the most common disorders in Pugs. Identification of health priorities based on VetComapss data can support evidence–based reforms to improve health and welfare within the breed. Electronic supplementary material The online version of this article (doi:10.1186/s40575-016-0035-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Dan G O'Neill
- Production and Population Health, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts AL9 7TA UK
| | - Elisabeth C Darwent
- Production and Population Health, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts AL9 7TA UK
| | - David B Church
- Clinical Sciences and Services, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts AL9 7TA UK
| | - Dave C Brodbelt
- Production and Population Health, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts AL9 7TA UK
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Lacerda RP, Peña Gimenez MT, Laguna F, Costa D, Ríos J, Leiva M. Corneal grafting for the treatment of full-thickness corneal defects in dogs: a review of 50 cases. Vet Ophthalmol 2016; 20:222-231. [PMID: 27241238 DOI: 10.1111/vop.12392] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To describe corneal grafting for the treatment of full-thickness corneal defects in dogs and to determine its effectiveness in preserving vision. METHODS A review of the medical records of dogs that underwent corneal grafting following corneal perforations (≥3 mm) at the VTH-UAB from 2002 to 2012 was carried out. RESULTS Fifty dogs of different breed, age and gender were included. Brachycephalic breeds were overrepresented (37/50;74%). All cases were unilateral, with euryblepharon being the most common concurrent ocular abnormality (20/50;40%). Full-thickness penetrating keratoplasties (FTPK) were performed in 21/50 eyes (42%) and lamellar keratoplasties (LK) in 29/50 eyes (58%). Frozen grafts (FroG) were used in 43/50 eyes (86%) and fresh homologous grafts (FreHoG) in 7/50 (14%). Of the former group, 26 were homologous (FroHoG:60%) and 17 heterologous (FroHeG:40%). A combination of topical medication (antibiotics, corticosteroids, cycloplegics, and 0.2% cyclosporine A) and systemic mycophenolate mofetil was administered. Median follow-up time was 200 days. Postsurgical complications included wound dehiscence (6/50;12%) and glaucoma (4/50;8%). Clinical signs of graft rejection were diagnosed as follows: FroHoG (13/26;50%), FroHeG (11/17;65%), FreHoG (4/7;57%), FTPK (12/21;57%), and LK (16/29;55%). Medical treatment successfully controlled graft rejection in 11/28 eyes (39%). Good anatomical outcome was achieved in 86% (43/50), of which 95% (41/43) were visual at last examination, with moderate opacification to complete transparency of the graft present in 48.2%. CONCLUSIONS Corneal grafting is an effective surgical treatment for full-thickness corneal defects in dogs. If graft rejection is present, additional medical or surgical therapy may be necessary, achieving a highly satisfactory visual outcome.
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Affiliation(s)
- Rodrigo P Lacerda
- Servei d'Oftalmologia, Fundació Hospital Clínic Veterinari, Carrer del Hospital s/n, Bellaterra, Barcelona, 08193, Spain
| | - Maria T Peña Gimenez
- Departament de Medicina i Cirurgia Animal, Facultat de Veterinària, Universitat Autònoma de Barcelona, Edific V, Campus UAB, Bellaterra, Barcelona, 08193, Spain
| | - Fernando Laguna
- Servei d'Oftalmologia, Fundació Hospital Clínic Veterinari, Carrer del Hospital s/n, Bellaterra, Barcelona, 08193, Spain
| | - Daniel Costa
- Departament de Medicina i Cirurgia Animal, Facultat de Veterinària, Universitat Autònoma de Barcelona, Edific V, Campus UAB, Bellaterra, Barcelona, 08193, Spain
| | - Jose Ríos
- Medical Statistics Core Facility, DIBAPS (Hospital Clínic), Barcelona, 08036, Spain
| | - Marta Leiva
- Departament de Medicina i Cirurgia Animal, Facultat de Veterinària, Universitat Autònoma de Barcelona, Edific V, Campus UAB, Bellaterra, Barcelona, 08193, Spain
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Scherrer NM, Lassaline M, Miller WW. Corneal edema in four horses treated with a superficial keratectomy and Gundersen inlay flap. Vet Ophthalmol 2016; 20:65-72. [DOI: 10.1111/vop.12342] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Nicole M. Scherrer
- New Bolton Center; University of Pennsylvania School of Veterinary Medicine; 382 West Street Rd Kennett Square PA 19348 USA
| | - Mary Lassaline
- Department of Radiological and Surgical Sciences; University of California; 1 Shields Ave Davis CA 95616 USA
| | - William W. Miller
- Memphis Veterinary Specialists; 555 Trinity Creek Cove Cordova TN 38018 USA
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Abstract
Corneal emergencies can be due to a number of different causes and may be vision threatening if left untreated. In an attempt to stabilize the cornea, it is of benefit to place an Elizabethan collar on the patient to prevent further corneal damage. This article discusses the diagnosis, prognosis, and management of corneal emergencies in dogs and cats.
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Chow DW, Westermeyer HD. Retrospective evaluation of corneal reconstruction using ACell Vet™alone in dogs and cats: 82 cases. Vet Ophthalmol 2015; 19:357-66. [DOI: 10.1111/vop.12294] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Derek W.Y. Chow
- Veterinary Specialty Hospital, Hong Kong; 1/F & 2/F 165 Wanchai Road Wan Chai, Hong Kong Island Hong Kong SAR China
| | - Hans D. Westermeyer
- Department of Clinical Sciences; North Carolina State University College of Veterinary Medicine; 1060 William Moore Drive Raleigh NC 27606 USA
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Laguna F, Leiva M, Costa D, Lacerda R, Peña Gimenez T. Corneal grafting for the treatment of feline corneal sequestrum: a retrospective study of 18 eyes (13 cats). Vet Ophthalmol 2014; 18:291-6. [DOI: 10.1111/vop.12228] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Fernando Laguna
- Fundació Hospital Clínic Veterinari; Universitat Autónoma de Barcelona; Spain
| | - Marta Leiva
- Fundació Hospital Clínic Veterinari; Universitat Autónoma de Barcelona; Spain
- Departament de Medicina i Cirurgia Animals; Facultat de Veterinària, Universitat Autònoma de; Barcelona Spain
| | - Daniel Costa
- Departament de Medicina i Cirurgia Animals; Facultat de Veterinària, Universitat Autònoma de; Barcelona Spain
| | - Rodrigo Lacerda
- Fundació Hospital Clínic Veterinari; Universitat Autónoma de Barcelona; Spain
| | - Teresa Peña Gimenez
- Fundació Hospital Clínic Veterinari; Universitat Autónoma de Barcelona; Spain
- Departament de Medicina i Cirurgia Animals; Facultat de Veterinària, Universitat Autònoma de; Barcelona Spain
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26
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Azoulay T. Adjunctive cryotherapy for pigmentary keratitis in dogs: a study of 16 corneas. Vet Ophthalmol 2013; 17:241-9. [DOI: 10.1111/vop.12089] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Thierry Azoulay
- Clinique vétérinaire des Halles; 28 Faubourg de Saverne 67000 Strasbourg France
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Abstract
PURPOSE To assess integration of a biosynthetic corneal implant in dogs. METHODS Three normal adult laboratory Beagles underwent ophthalmic examinations, including slit-lamp biomicroscopy, indirect ophthalmoscopy, applanation tonometry, and Cochet-Bonnet aesthesiometry. Biosynthetic corneas fabricated from glutaraldehyde crosslinked collagen and copolymers of collagen and poly(N-isopropylacrylamide-co-acrylic acid-co-acryloxysuccinimide, denoted as TERP) were implanted into dogs by a modified epikeratoplasty technique. Ophthalmic examinations and aesthesiometry were performed daily for 5 days and then weekly thereafter for 16 weeks. Corneal samples underwent histopathological and transmission electron microscopy examination at 16 weeks. RESULTS Implants were epithelialized by 7 days. Intraocular pressure was within normal range throughout the study. Aesthesiometry values dropped from an average of 3.67 cm preoperatively to less than 1 mm for all dogs for the first postoperative weeks. By week 16, the average Cochet-Bonnet value was 1.67 cm, demonstrating partial recovery of functional innervation of the implant. No inflammation or rejection of the implant occurred, and minimal haze formation was noted. Light microscopy revealed thickened but normal epithelium over the implant with fibroblast migration into the scaffold. On transmission electron microscopy, the basement membrane was irregular but present and adhesion complexes were noted. CONCLUSION Biosynthetic corneal implantation is well tolerated in dogs, and the collagen-polymer hybrid construct holds promise for clinical application in animals and humans.
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28
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Isard PF, Dulaurent T, Regnier A. Keratoprosthesis with retrocorneal fixation: preliminary results in dogs with corneal blindness. Vet Ophthalmol 2010; 13:279-88. [DOI: 10.1111/j.1463-5224.2010.00800.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Fowler WC, Chang DH, Roberts BC, Zarovnaya EL, Proia AD. A new paradigm for corneal wound healing research: The white leghorn chicken (Gallus gallus domesticus). Curr Eye Res 2009; 28:241-50. [PMID: 15259293 DOI: 10.1076/ceyr.28.4.241.27837] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To evaluate the chicken cornea as a model for corneal wound healing research. METHODS We conducted studies on normal chicken corneas and on corneas following mechanical debridement and photorefractive keratectomy (PRK). RESULTS The chicken cornea possesses six distinct layers that resemble the layers of the human cornea, including a substantial Bowman's layer measuring 5.2 +/- 0.3 microm thick. Reepithelialization time was 44.8 +/- 1.1 hours with a sliding rate of 75.3 +/- 3.2 microm/hour following mechanical debridement and 54.4 +/- 2.8 hours with a sliding rate of 63.3 +/- 3.2 microm/hour for PRK-treated corneas. Biomicroscopic haze post-PRK peaked at 4-6 weeks and regressed until 20 weeks post-PRK. Histologic and clinical observations of wound healing strongly paralleled that noted in humans. CONCLUSION The chicken cornea's morphology and wound healing response render it a useful model for corneal wound healing investigations.
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Affiliation(s)
- W Craig Fowler
- Department of Ophthalmology and Free Electron Laser Laboratory, Duke University Center, Durham, NC 27710, USA
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31
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Townsend WM, Rankin AJ, Stiles J, Krohne SG. Heterologous penetrating keratoplasty for treatment of a corneal sequestrum in a cat. Vet Ophthalmol 2008; 11:273-8. [DOI: 10.1111/j.1463-5224.2008.00634.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Today, corneal wounds are repaired using nylon sutures. Yet there are a number of complications associated with suturing the cornea, and thus there is interest in an adhesive to replace or supplement sutures in the repair of corneal wounds. We are designing and evaluating corneal adhesives prepared from dendrimers--single molecular weight and highly branched polymers. We have explored two strategies to form these ocular adhesives. The first involves a photocrosslinking reaction and the second uses a peptide ligation reaction to couple the individual dendrimers together to form the adhesive. These adhesives were successfully used to repair corneal perforations, close the flap produced in a LASIK procedure, and secure a corneal transplant.
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Affiliation(s)
- Mark W Grinstaff
- Department of Biomedical Engineering, Metcalf Center for Science and Engineering, Boston University, Boston, MA 02215, USA.
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33
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Ledbetter EC, Munger RJ, Ring RD, Scarlett JM. Efficacy of two chondroitin sulfate ophthalmic solutions in the therapy of spontaneous chronic corneal epithelial defects and ulcerative keratitis associated with bullous keratopathy in dogs. Vet Ophthalmol 2006; 9:77-87. [PMID: 16497231 DOI: 10.1111/j.1463-5224.2006.00439.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To determine the efficacy of two antimicrobial-chondroitin sulfate ophthalmic solutions in the therapy of spontaneous chronic corneal epithelial defects (SCCED) and ulcerative keratitis associated with bullous keratopathy in dogs. ANIMALS STUDIED Eighty dogs with SCCED and 14 dogs with ulcerative keratitis associated with bullous keratopathy. PROCEDURE Following manual debridement of nonadherent epithelium, dogs were treated topically with a chondroitin sulfate ophthalmic solution containing either tobramycin or ciprofloxacin. Patients were re-evaluated at 2-week intervals for 4 weeks. RESULTS After 2 weeks of treatment, 53.6% of eyes with SCCED and 17.6% of eyes with ulcerative keratitis associated with bullous keratopathy had healed. After 4 weeks of treatment, 81.0% of eyes with SCCED and 23.5% of eyes with ulcerative keratitis associated with bullous keratopathy had healed. There were no statistically significant differences in healing percentages between the tobramycin-chondroitin sulfate solution treatment groups and the ciprofloxacin-chondroitin sulfate solution treatment groups. Two dogs with SCCED, one treated with the tobramycin-chondroitin sulfate solution and the other treated with the ciprofloxacin-chondroitin sulfate solution, developed sterile corneal stromal abscesses during the study. CONCLUSIONS Topical therapy with an antimicrobial-chondroitin sulfate ophthalmic solution combined with manual debridement of nonadherent epithelium compares favorably with other published medical and surgical therapies for SCCED; however, these compounds are only equivocally more effective than therapy with manual debridement alone. These solutions appear to be ineffective in the treatment of ulcerative keratitis associated with bullous keratopathy. The significance of the two cases of corneal stromal abscessation is unknown at this time and warrants further investigation.
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Affiliation(s)
- Eric C Ledbetter
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853-6401,USA.
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34
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Esson DW, Wellehan JFX, Lafortune M, Valverde A, Citino SB. Surgical management of a malacic corneal ulcer in a greater one-horned Asian rhinoceros (Rhinoceros unicornis) using a free island tarsoconjunctival graft. Vet Ophthalmol 2006; 9:65-9. [PMID: 16409248 DOI: 10.1111/j.1463-5224.2005.00440.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A greater one-horned Asian rhinoceros (Rhinoceros unicornis) presented for presumed ocular trauma to the left eye, with secondary bacterial infection, resulting in severe and progressive corneal ulceration. Following a poor response to medical therapy, the animal was anesthetized for further examination, and a bulbar conjunctival pedicle graft performed. This graft failed by 48-h postsurgery as a result of self-trauma. The animal was re-anesthetized, and a free island tarsoconjunctival graft performed. This second procedure was successful, resulting in globe preservation, cosmesis, and functional vision in the affected eye.
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Affiliation(s)
- Douglas W Esson
- Eye Care for Animals, Tustin, CA 92780, and College of Veterinary Medicine, University of Florida, Gainesville 32610, USA.
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35
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Bussieres M, Krohne SG, Stiles J, Townsend WM. The use of porcine small intestinal submucosa for the repair of full-thickness corneal defects in dogs, cats and horses. Vet Ophthalmol 2004; 7:352-9. [PMID: 15310296 DOI: 10.1111/j.1463-5224.2004.04055.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the efficacy of using a porcine small intestinal submucosa (SIS) graft covered by a conjunctival flap for the surgical repair of full-thickness corneal wounds in dogs, cats and horses. PROCEDURE All records dating from August 1999 to February 2003 from Purdue University Veterinary Teaching Hospital of patients that had undergone ophthalmic surgical procedures and received a SIS corneal graft for a full-thickness lesion were reviewed. Fifteen cases were identified including six dogs, two cats and seven horses. Requirements for inclusion in this study were that SIS was used as a corneal graft in a full-thickness corneal defect and that the graft was completely covered with a conjunctival flap. RESULTS Of the 15 cases, one canine patient had received SIS following removal of an epibulbar melanocytoma. The remaining five canine patients had undergone this surgical procedure for the repair of corneal perforation. The two feline patients had been presented for corneal perforation following chronic ulceration. One equine patient had been presented for a deep melting ulcer, three for stromal corneal abscesses, and three for corneal perforations. Complications encountered postoperatively included aqueous leakage, conjunctival flap dehiscence, synechia, cataract and fibrin in the anterior chamber. Fourteen out of 15 patients were visual at the final re-evaluation. CONCLUSION SIS is an inexpensive, easy-to-handle biomaterial that appears to be suitable for the repair of full-thickness corneal wounds in dogs, cats and horses. Results of our study support the conclusion that this relatively new product is an effective alternative to traditional implantation materials utilized in veterinary ophthalmology.
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Abstract
Corneal disease is common in equine ophthalmology and requires vigilant monitoring and appropriate therapy to optimize the outcome. Many equine corneal diseases, particularly those that progress rapidly, may benefit from surgical intervention. These include descemetoceles, deep corneal lacerations and ulcers, corneal perforation/iris prolapse, ulcerative keratitis, corneal stromal abscesses, and corneoscleral neoplasia. Indications for corneal transplantation include optical, tectonic, therapeutic, and cosmetic purposes. Corneal transplantation is most often implemented in equine patients for tectonic and therapeutic reasons when a cornea is compromised by corneal stromal abscess, iris prolapse, or neoplasia. This article provides an outline of when to consider surgical intervention for corneal disease, the procedures available and expected outcomes, and how appropriate early surgical intervention can dramatically improve the end result.
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Affiliation(s)
- Heidi M Denis
- Animal Eye Associates, 9901 South US Highway 17/92, Maitland, FL 32751, USA.
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37
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Moore PA. Diagnosis and management of chronic corneal epithelial defects (indolent corneal ulcerations). ACTA ACUST UNITED AC 2003; 18:168-77. [PMID: 14604091 DOI: 10.1016/s1096-2867(03)90013-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Chronic corneal epithelial defects (CCEDs; indolent corneal ulcerations) are the most common refractory ulcerations in veterinary medicine and are diagnosed by their classic appearance. CCEDs are superficial ulcerations without stromal involvement and have a nonadherent epithelial border (lip). Fluorescein stain adheres to the exposed stroma and extends below the epithelial border, outlining the epithelial lip. CCEDs occur secondary to adnexal disease, keratoconjunctivitis sicca, exposure keratitis, neurotrophic keratitis, and primary corneal disease. In cats, herpes keratitis is associated with the development of CCEDs. Bacterial infections are not responsible for the refractory nature of CCEDs. Because of the refractory nature of CCEDs, treatment can be frustrating for both owner and veterinarian. Current treatment recommendations consist of identifying and treating the underlying cause and performing procedures that stimulate epithelialization and adhesion of the corneal epithelium. Initial treatment of CCEDs includes ulcer debridement and grid keratotomy. Superficial keratectomy is indicated in refractory cases.
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Affiliation(s)
- Phillip Anthony Moore
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, The University of Georgia, GA 30602, USA
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38
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Abstract
Although challenging from a technical perspective, many corneal surgical procedures can be mastered by the general practitioner. This article describes a number of procedures that can potentially save both the eye and vision. Procedures include corneal laceration repair, conjunctival pedicle graft, tarsoconjunctival island graft, advancement graft, total conjunctival graft, frozen tectonic corneal graft, porcine small-intestine submucosa graft, and superficial keratectomy. In addition to considerations on how to properly perform these procedures, emphasis is placed on common causes of failure and how to avoid them.
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Affiliation(s)
- Steven R Hollingsworth
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, Hall, Room 2112, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
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39
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Abstract
The cornea is the anterior, transparent portion of the fibrous tunic of the eye. It is continuous with the sclera at a transition called the limbus. In healthy conditions, the transparency of the cornea is maintained by the smooth, nonkeratinized, squamous epithelium, which is further enhanced by the precorneal tear film, the lack of corneal vascularization or pigmentation, the size and regular arrangement of the collagen fibrils that make up the corneal stroma, and the relative dehydration of the cornea (which is maintained by the endothelium and epithelium). The cornea can respond to adverse stimuli through vascularization, pigmentation, fibrosis, accumulation of cellular or noncellular infiltrate, and/or edema. Because of these limited responses, routine diagnostic procedures are critical in the diagnosis and treatment of corneal disorders. This article discusses tests of the precorneal tear film, corneal staining procedures, culture and sensitivity, cytology, and a few other procedures that are performed less commonly or require specialized instrumentation.
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Affiliation(s)
- Raymond J Morreale
- Michigan Veterinary Specialists, 21600 W. Eleven Mile Road, Southfield, Ml 48076, USA
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40
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Abstract
Corneal fungal diseases, including fungal keratitis and stromal abscess, are uncommon in small animals. Ocular infection secondary to systemic mycosis is reported far more frequently. Suspicion of a fungal corneal ulcer should be raised based on a history of underlying trauma, especially with plant material, geographic location, chronic use of topical antibiotics or corticosteroids, or an extremely prolonged course of disease despite appropriate treatment. Clinical signs observed with fungal keratitis may include blepharospasm, epiphora, miosis, corneal opacity, and vascularization. Unfortunately, none of these signs is specific to fungal infection. If fungal keratitis is suspected or confirmed, then aggressive medical therapy should be instituted. Medications used include topical antifungals, parasympatholytics, anticollagenases, and antibacterials as well as systemic anti-inflammatory drugs. Because there are very few fungicidal medications, the course of medical treatment for fungal corneal disease requires a prolonged duration with frequent re-examination and assessment. Surgical treatment is sometimes required to save the eye and vision. Surgeries to be considered include debridement, conjunctival graft placement, and corneal transplantation.
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Affiliation(s)
- Stacy E Andrew
- Georgia Veterinary Specialists, 455 Abernathy Road NE, Atlanta, GA 30328, USA.
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41
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Abstract
The most commonly performed feline ocular surgeries are described with emphasis on any anatomic or pathophysiologic differences that are unique to the feline eye, adnexa, and orbit.
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Affiliation(s)
- Ralph E Hamor
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, 1008 West Hazelwood Drive, Urbana, IL 61802, USA.
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Abstract
A Boston Terrier puppy presented with a full-thickness peripheral corneal defect, iris prolapse and anterior lens capsule tear in the left eye (OS). Phacofragmentation and primary repair of the corneal laceration was performed. At surgery, subluxation of the lens was also apparent. One day postoperative, there was severe corneal edema, diffuse hyphema, an intraocular pressure (IOP) of 65 mmHg and a small amount of vitreous that protruded from the corneal incision OS. Malignant glaucoma or pupillary block glaucoma were suspected. Intravenous mannitol was administered preoperatively and had no effect. An anterior vitrectomy was performed on the vitreous within the anterior chamber and pupil. One day postoperative the IOP was 16 mmHg in the right eye (OD) and 20 mmHg OS. Postoperative iridocyclitis was managed medically, and additional elevations in IOP were not recorded. Resolution of the elevated IOP following anterior vitrectomy was supportive of pupillary block or malignant glaucoma. Vision returned 3 weeks after the initial surgery. Two years after the initial injury, the eye is visual and comfortable with infrequent topical anti-inflammatory therapy.
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Abstract
Laser technology continues to progress with the addition of new lasers, new delivery systems, and new applications. The introduction of lasers to veterinary ophthalmology has radically changed the level of care that we can provide to our patients. The development of the diode laser has particularly had an impact on veterinary ophthalmology. The diode's affordability, portability, and broad applications for veterinary patients have allowed laser surgery to become a routine part of veterinary ophthalmology practice. Educating the public and veterinary community in available laser techniques will generate improved ophthalmic care and provide more data on which to build future applications.
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Affiliation(s)
- Margi A Gilmour
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Oklahoma State University, Stillwater, OK 74078, USA.
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Ollivier F, Delverdier M, Regnier A. Tolerance of the rabbit cornea to an n-butyl-ester cyanoacrylate adhesive (Vetbond). Vet Ophthalmol 2001; 4:261-6. [PMID: 11906661 DOI: 10.1046/j.1463-5216.2001.00195.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE An n-butyl-ester cyanoacrylate adhesive available for veterinary surgery (Vetbond, 3M) was tested in rabbits for corneal irritation. PROCEDURES Two experimental procedures were used on 24 rabbits: injection of the adhesive into an intralamellar corneal pocket (n = 10) and application of the glue to a mid-stromal corneal defect (n = 14). In both experiments the eyes were examined for 20 days for evidence of corneal irritation and tolerance. At the end of each experiment, histopathologic studies were performed on all corneas. RESULTS The corneal reaction to the intrastromally injected cyanoacrylate was characterized clinically by slight edema and vascularization localized to the vicinity of the adhesive. A moderate foreign body-type reaction was found histologically. Following application of the adhesive to a central stromal defect, the treated corneas remained totally clear and histopathologic examination showed that the healing process was not altered compared to the controls. The mean retention time of the glue patch was 14 days. CONCLUSIONS Intrastromal injection and surface application to a corneal defect of n-butyl-ester cyanoacrylate to a corneal defect induced only a mild inflammatory response and did not interfere with the reparative process. These findings suggest that this surgical adhesive would be acceptable for treating corneal ulcerations in animals.
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Affiliation(s)
- F Ollivier
- University of Florida, College of Veterinary Medicine, Small Animal Clinical Sciences, Gainesville, FL, USA
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Peña Gimenez M, Fariña I. Lamellar keratoplasty for the treatment of feline corneal sequestrum. Vet Ophthalmol 2001; 1:163-161. [PMID: 11397226 DOI: 10.1046/j.1463-5224.1998.00031.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A lamellar keratoplasty was used to treat corneal sequestrum in four Persian cats (six eyes). Following a superficial keratectomy, lamellar corneal allografts (feline corneal tissue) or heterografts (canine corneal tissue) which had been preserved at -20 degrees C were placed in the recipient cornea. All grafts became optically transparent within 2 months following surgery and no recurrences of the sequestrum have been noted during the follow-up period (4-30 months). We conclude that feline corneal sequestrum may be successfully treated with feline or canine donor corneal tissue using this technique.
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Affiliation(s)
- M.T.P. Peña Gimenez
- Department of Surgery, College of Veterinary Medicine, Autonomous University of Barcelona, 08193, Bellaterra, Barcelona, Spain; Department of Surgery, College of Veterinary Medicine, University of the Grand Canary Islands, Transmontaña 35416 Arucas, Las Palmas, Spain
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46
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Hansen PA, Guandalini A. A retrospective study of 30 cases of frozen lamellar corneal graft in dogs and cats. Vet Ophthalmol 2001; 2:233-241. [PMID: 11397271 DOI: 10.1046/j.1463-5224.1999.00084.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Frozen lamellar corneal grafts and nictitating membrane flaps were used in 18 dogs and 12 cats to repair deep corneal defects. In all dogs either melting corneal ulcers or descemetoceles were present. In the 12 cats, nine had either a melting corneal ulcer or descemetocele, two animals had acute bullous keratopathy, and one cat had corneal sequestrum. Initial vascularization with gradual clearing of the graft occurred during the first 45 days postoperatively. At 60 days postoperatively, all eyes were visual. Frequent postoperative complications included: focal dehiscence of the wound (n = 9); melting of part of the graft (n = 7); and pigmentation of the graft (n = 4). The frozen lamellar corneal graft was a very safe technique, and restored the tectonic and the optical function of the cornea. It provided the best results in corneas with nonperforating corneal defects. This technique provides poorer results when the cornea was perforated prior to surgery or during the surgical procedure.
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Affiliation(s)
- Philippe A. Hansen
- 46 Ave du roi chevalier, 1200 Brussels, Belgium; Circonvallatione nomentana 251, 00162 Rome, Italy
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Andrew SE, Tou S, Brooks DE. Corneoconjunctival transposition for the treatment of feline corneal sequestra: a retrospective study of 17 cases (1990-1998). Vet Ophthalmol 2001; 4:107-11. [PMID: 11422991 DOI: 10.1046/j.1463-5224.2001.00181.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To describe and evaluate the use of corneoconjunctival transposition as a surgical treatment for corneal sequestra in cats. ANIMALS STUDIED Fifteen cats (17 eyes) of various breeds and ages with corneal sequestra treated surgically with corneoconjunctival transposition. PROCEDURE Retrospective medical records study. RESULTS Median age was 39 months. Eight patients were castrated males, five were spayed females, and two were intact females. The left eye was affected in eight cats, the right eye was affected in five cats, and both eyes were affected in two cats. Mean (+/- SD) sequestrum diameter was 4.4 +/- 2.4 mm (range 1-10 mm) and the sequestrum was located centrally in all cases. Sequestra occurred in the superficial stroma in 8/17 corneas, in the anterior one third of the stroma in 3/17 corneas, and in the middle one third of the stroma in 6/17 corneas. Median duration of clinical signs prior to presentation was 39 days (range 14-1095 days). Median time to healing, defined as the number of days from surgery to cessation of medical treatment, was 34 days (range 25-86 days). There were no recurrences and minimal scar formation. CONCLUSIONS Corneoconjunctival transposition is a valid procedure for surgical treatment of corneal sequestra in cats. The procedure results in excellent cosmesis and functional vision with no recurrences.
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Affiliation(s)
- S E Andrew
- Department of Small Animal Clinical Sciences, University of Florida, College of Veterinary Medicine, PO Box 100126, Gainesville, FL 32610-0126, USA.
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Featherstone HJ, Sansom J, Heinrich CL. The use of porcine small intestinal submucosa in ten cases of feline corneal disease. Vet Ophthalmol 2001; 4:147-53. [PMID: 11422997 DOI: 10.1046/j.1463-5224.2001.00192.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Porcine small intestinal submucosa (SIS) was used as a novel graft material in the management of 10 cases of feline corneal disease. Five cases had stromal ulceration associated with trauma, ocular foreign body and/or suspected infection and required a grafting procedure. Five cases had feline sequestra that were managed by a keratectomy prior to placement of SIS as a graft material. Eight eyes healed with minimal corneal scarring with a very good cosmetic and visual result. One eye with continued aqueous leakage in the immediate postoperative period required a conjunctival pedicle graft to reinforce the SIS graft site. One eye required enucleation 48 h following grafting due to progressive keratomalacia but the SIS material remained intact.
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Affiliation(s)
- H J Featherstone
- Comparative Ophthalmology Unit, Center for Small Animal Studies, Animal Health Trust, Lanwades Park, Kentford, Newmarket, Suffolk, CB8 7UU, UK.
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Abstract
Bacterial infections are frequently associated with diseases of the eyelids, cornea, and conjunctiva. Animals sustaining KCS commonly have bacterial infections of the external eye owing to a lack of antimicrobial properties present in the normal tearfilm. Infection can occur in the nasolacrimal duct or lacrimal sac, which is referred to as dacryocystitis. Severe corneal ulcers are frequently infected with bacteria, especially Pseudomonas sp. Three new topical ophthalmic antibiotics have recently become commercially available: ciprofloxacin, norfloxacin, and ofloxacin.
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Affiliation(s)
- R D Whitley
- Department of Small Animal Surgery and Medicine, College of Veterinary Medicine, Auburn University, Alabama, USA.
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Abstract
There are few ocular emergencies that are unique to the pediatric patient. Most ocular emergencies are traumatic in origin, and the prognosis is often determined by the extent of the injury. Some congenital anomalies that may present as ocular emergencies are also discussed. The focus of this article is recognition and initial therapy for the more common pediatric ocular emergencies.
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Affiliation(s)
- H L Hamilton
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, USA
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