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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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Luo J, Zhou Z. Application of multi-layer porcine small intestinal submucosa for the reconstruction of deep corneal defects in cats. Vet Ophthalmol 2024. [PMID: 38413368 DOI: 10.1111/vop.13196] [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: 06/13/2023] [Revised: 01/26/2024] [Accepted: 02/11/2024] [Indexed: 02/29/2024]
Abstract
OBJECTIVE This study documented the application of porcine small intestinal submucosa (SIS) as a stand-alone scaffold for treating deep corneal defects in cats. METHODS Medical records of 20 cats with deep stromal ulcers, perforations, or corneal sequestra that underwent surgical treatment with SIS grafts between 2021 and 2022 were retrospectively reviewed. Data on re-epithelialization time, corneal transparency score, and complications were collected to analyze the reconstruction of deep corneal defects after SIS biomaterial implantation. RESULTS All cats were unilaterally affected. The corneal defects varied in size, with a median diameter of 8.3 mm (range: 3-15 mm). Re-epithelialization of the SIS graft was completed 16-32 days after surgery (median, 22.3 days). No, mild, or moderate corneal transparency was detected in 90% of the cases. Complications were observed in eight cases (40%), including aqueous leakage (10%), partial SIS malacia (25%), and persistent bullous keratopathy (5%). The follow-up period ranged 90-725 days, with a median duration of 255 days. The SIS graft was successfully applied as a single scaffold in 17 of 20 cases (85%). CONCLUSION The results of this study suggest that the application of commercial SIS is an effective surgical technique for managing deep corneal defects in cats.
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Affiliation(s)
- JingWen Luo
- The Department of Clinical Sciences, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu, China
- Focu Pet hospital, WuXi, Jiangsu, China
| | - ZhenLei Zhou
- The Department of Clinical Sciences, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu, China
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Kim KY, Oh M, Kim M. Treatment of a Large Tibial Non-Union Bone Defect in a Cat Using Xenograft with Canine-Derived Cancellous Bone, Demineralized Bone Matrix, and Autograft. Animals (Basel) 2024; 14:690. [PMID: 38473075 DOI: 10.3390/ani14050690] [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: 01/10/2024] [Revised: 02/16/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024] Open
Abstract
A 17-month-old domestic short-hair cat was referred due to a non-union in the left tibia. The initial repair, conducted 3 months prior at another animal hospital, involved an intramedullary (IM) pin and wire to address a comminuted fracture. Unfortunately, the wire knot caused a skin tract, resulting in osteomyelitis. Although the wire knot was removed at that hospital, the draining tract persisted, continuously discharging exudate. Upon evaluation, the first surgery was reassessed and revised, involving the removal of the IM pin and the application of external skeletal fixation alongside an antibiotic susceptibility test. After 118 days post-revision surgery, while some cortical continuity was observed, a significant bone defect persisted, posing a substantial risk of refracture should the implant be removed. A second revision surgery was performed, utilizing a bone plate combined with cancellous bone autograft, recombinant human bone morphogenetic protein-2, and xenograft featuring a canine-derived cancellous chip mixed with demineralized bone matrix. Remarkably, the bone completed its healing within 105 days following the subsequent surgery. Radiography demonstrated successful management of the large bone defect up to the 2-year postoperative check-up. During telephone follow-ups for 3.5 years after surgery, no complications were identified, and the subject maintained a favorable gait.
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Affiliation(s)
- Keun-Yung Kim
- Fatima Animal Medical Center, Daegu 41216, Republic of Korea
| | - Minha Oh
- Veteregen, Hanam 12930, Republic of Korea
| | - Minkyung Kim
- Keunmaum Animal Medical Center, Busan 48096, Republic of Korea
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Song X, Liang Y, Zhou S, Xie W, Yang Q, Ma N, Shen X. Glutamine alleviates Lipopolysaccharide-induced corneal epithelial inflammation and oxidative stress in dogs. Exp Eye Res 2023; 234:109607. [PMID: 37517541 DOI: 10.1016/j.exer.2023.109607] [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] [Received: 04/18/2023] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 08/01/2023]
Abstract
Pseudomonas aeruginosa is a common pathogenic bacteria in canine ophthalmology. Lipopolysaccharide (LPS), a component in the cell wall of gram-negative bacteria, is released following bacterial lysis and causes pathology and inflammation of the cornea. Antibiotics are used to treat bacterial keratitis, and the reuse of antibiotics can easily cause bacterial resistance. Research has shown that glutamine (GLN) has anti-inflammatory and antioxidant biological functions. Herein, we explored the effects and underlying mechanisms of GLN and established an LPS-induced cornea inflammation model. Treatment groups comprised: control check (CK), LPS, LPS + GLN, and Sham groups. Topical GLN treatment alleviated corneal opacity, reduced corneal injury, and accelerated corneal wound healing. Furthermore, GLN treatment altered the uniform distribution of corneal epithelial cells and transformed the healing approach of these cells in the corneal wound from crawling to filling. The expression of Toll-like receptor 4 (TLR4), IL-6, TNF-α, and p-p65 and the activity of myeloperoxidase and superoxide dismutase decreased while the content of malondialdehyde increased in the LPS + GLN group compared with those in the LPS group. Thus, our study suggests that LPS-induced inflammation and oxidative stress may be suppressed via the TLR4/NF-κB signaling pathway by GLN and that GLN could be used as an adjunct therapy to reduce antibiotic use.
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Affiliation(s)
- Xiaokun Song
- Ministry of Education Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu, PR China
| | - Yuxuan Liang
- Ministry of Education Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu, PR China
| | - Shendong Zhou
- Ministry of Education Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu, PR China
| | - Wan Xie
- Ministry of Education Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu, PR China
| | - Qifeng Yang
- Ministry of Education Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu, PR China
| | - Nana Ma
- Ministry of Education Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu, PR China
| | - Xiangzhen Shen
- Ministry of Education Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu, PR China.
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Linn-Pearl R. Optimising treatment approaches for feline corneal sequestra to improve long-term clinical outcomes. Vet Rec 2023; 193:107-110. [PMID: 37539875 DOI: 10.1002/vetr.3334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
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Gómez AP, Mazzucchelli S, Smith K, de Lacerda RP. Long-term treatment outcomes and risk factors for recurrence in feline corneal sequestrum: 72 cases (2009-2017). Vet Rec 2023; 193:e2783. [PMID: 36912180 DOI: 10.1002/vetr.2783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND This study aimed to evaluate long-term treatment outcomes in feline corneal sequestrum (FCS), compare the recurrence rates between different surgical techniques, identify possible recurrence risk factors and monitor the development of FCS in the contralateral eye. METHODS The medical records of 72 cats (79 eyes) with FCS treated between 2009 and 2017 were retrospectively analysed. RESULTS The most commonly affected breeds were Persian, domestic shorthaired and Burmesecats. The mean age was 6.9 years. Sixty-five cats (90%) were affected unilaterally. Sixty-six eyes (83%) underwent surgery: keratectomy in 34 eyes (52%) and keratectomy followed by a graft procedure in 32 eyes (48%). Recurrence occurred in 13 out of 66 eyes (19%) at a median of 245 days after surgery. Skull conformation, location of the FCS, type of surgical procedure and concurrent ocular surgery did not significantly affect the recurrence rate. Eighteen cats (27%) developed FCS in the contralateral eye at a median of 635 days after surgery. LIMITATIONS Limitations are related to the retrospective nature of the study, the use of telephone follow-up for assessment of recurrence in some cats and the small number of cases. CONCLUSIONS Surgical excision had a successful outcome in most cases. The type of surgical procedure and skull conformation did not affect the recurrence rate. One-quarter of the cats developed FCS in the contralateral eye.
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Affiliation(s)
| | | | - Kinley Smith
- Willows Veterinary Centre & Referral Service, Solihull, UK
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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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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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Sarfaty H, Ezra-Elia R, Sebbag L. Prevalence and characteristics of ocular diseases in Sphynx cats: A retrospective assessment (2012-2021) and comparison with non-Sphynx cats. Vet Ophthalmol 2022; 25:367-375. [PMID: 35598106 DOI: 10.1111/vop.12994] [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: 11/09/2021] [Revised: 05/08/2022] [Accepted: 05/08/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE To describe the prevalence of ocular diseases in Sphynx cats, and compare disease characteristics with other feline breeds. METHODS Medical records of Sphynx cats presented to an ophthalmology referral center between 1/2012 and 4/2021 were examined. Cats of other breeds examined during the same period served as controls. RESULTS One hundred ten Sphynx cats were examined during the study period, diagnosed with corneal sequestrum (n = 42 cats), lower eyelid entropion (n = 25), presumed herpetic keratoconjunctivitis (n = 19), conjunctivitis (n = 7), corneal ulcers (n = 6), nasolacrimal duct atresia/obstruction (n = 6), corneal dystrophy (n = 3), eosinophilic keratitis (n = 2), uveitis (n = 2), non-ulcerative keratitis (n = 1), and cataract (n = 1). Corneal sequestrum was significantly more common in Sphynx versus non-Sphynx cats (odds ratio = 8.0, 95% CI = 5.3-12.2, p < .001), and age of diagnosis was significantly younger in Sphynx cats (2.0 ± 1.5 years vs. 5.9 ± 4.0 years, p < .001). Corneal sequestrum recurrence was noted in 19.4% Sphynx eyes and 6.4% non-Sphynx eyes undergoing surgery (p = .015). Lower eyelid entropion-most often bilateral (80%)-was significantly more common in Sphynx versus non-Sphynx cats (odds ratio = 4.1, 95% CI = 2.3-7.1, p < .001), and age of diagnosis was significantly younger in Sphynx cats (0.9 ± 1.4 years vs. 3.5 ± 3.3 years, p < .005). CONCLUSIONS Corneal sequestrum and entropion were overrepresented and diagnosed at an earlier age in Sphynx cats when compared with the general feline population. Given the high prevalence, early age of onset, and relatively high recurrence of corneal sequestrum in Sphynx cats, further studies are warranted to better understand etiopathogenesis and preferred therapies.
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Affiliation(s)
| | | | - Lionel Sebbag
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
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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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Xu H, Sapienza JS, Jin Y, Lin J, Zheng X, Dong H, Diao H, Zhao Y, Gao J, Tang J, Feng X, Micceri D, Zeng H, Lin D. Lamellar Keratoplasty Using Acellular Bioengineering Cornea (BioCorneaVetTM) for the Treatment of Feline Corneal Sequestrum: A Retrospective Study of 62 Eyes (2018–2021). Animals (Basel) 2022; 12:ani12081016. [PMID: 35454262 PMCID: PMC9026742 DOI: 10.3390/ani12081016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/03/2022] [Accepted: 04/12/2022] [Indexed: 02/01/2023] Open
Abstract
Simple Summary Corneal sequestrum is a specific and common corneal disease in cats. Surgery treatment is the recommended option. Acellular bioengineering cornea (ABC) is a popular and effective corneal transplantation material. However, no study has been published to evaluate the effectiveness and outcome of ABC lamellar transplantation for the treatment of feline corneal sequestrum (FCS). The purpose of this retrospective study was to evaluate the surgical effect of ABC lamellar transplantation in the treatment of FCS. All cats were diagnosed with FCS. All eyes received ABC lamellar transplantation for the first time, including 61 cats (62 eyes), aged 6–120 months. The average sequestrum size was 7.98 mm, with a medium of 7.75 mm (range, 4.75–11.75 mm), and the sequestrum thickness included 200 microns for 1 eye (1.61%), 300 microns for 28 eyes (45.16%), 400 microns for 29 eyes (46.77%), and 450 microns for 4 eyes (6.45%). All eyes retained vision after surgical treatment, and there was no recurrence during the follow-up period. This study has several limitations, including incomplete unification and standardization of data collection, some vacancies of follow-up time, inconsistency between then optical coherence tomography(OCT) examination and postoperative photo collection. Despite several limitations, our results show that ABC is easy to obtain and store, and has the choice of different sizes and thicknesses to achieve rapid corneal healing, and satisfactory visual and cosmetic effects in FCS treatment. Acellular bioengineering cornea can be a good alternative for the treatment of FCS. Abstract To retrospectively evaluate the effectiveness and outcome of lamellar keratoplasty using acellular bioengineering cornea (BioCorneaVetTM) for the treatment of feline corneal sequestrum (FCS). The medical records of cats diagnosed with FCS that underwent lamellar keratoplasty with BioCorneaVetTM between 2018 and 2021 with a minimum of 3 months of follow-up were reviewed. Follow-up examinations were performed weekly for 3 months, and then optical coherence tomography (OCT) examination was performed on select patients at 0, 3, 6, and 12 months post-operatively. A total of 61 cats (30 left eyes and 32 right eyes) were included. The Persian breed was overrepresented, 48/61 (78.69%). Four different thicknesses of acellular bioengineering cornea were used (200, 300, 400, or 450 microns), and the mean graft size was 8.23 mm (range, 5.00–12.00 mm). Minor complications were composed of partial dehiscence, and protrusion of the graft occurred in 7/62 eyes (11.29%). The median postoperative follow-up was 12.00 months (range, 3–41 months). A good visual outcome was achieved in 60/62 eyes (96.77%), and a mild to moderate corneal opacification occurred in 2/62 (3.23%). No recurrence of corneal sequestrum was observed. From the results, lamellar keratoplasty using acellular bioengineering cornea (BioCorneaVetTM) is an effective treatment for FCS, providing a good tectonic support and natural collagen framework, and resulting in satisfactory visual and cosmetic effects.
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Affiliation(s)
- Huihao Xu
- College of Veterinary Medicine, China Agricultural University, No. 2, Yuanmingyuan West Road, Haidian District, Beijing 100193, China; (H.X.); (Y.J.); (J.L.); (H.D.); (H.D.); (Y.Z.); (J.G.)
- College of Veterinary Medicine, Southwest University, No. 160, Xueyuan Road, Rongchang District, Chongqing 402460, China; (X.Z.); (J.T.); (X.F.); (H.Z.)
| | - John S. Sapienza
- Long Island Veterinary Specialists, Plainview, NY 11803, USA; (J.S.S.); (D.M.)
| | - Yipeng Jin
- College of Veterinary Medicine, China Agricultural University, No. 2, Yuanmingyuan West Road, Haidian District, Beijing 100193, China; (H.X.); (Y.J.); (J.L.); (H.D.); (H.D.); (Y.Z.); (J.G.)
| | - Jiahao Lin
- College of Veterinary Medicine, China Agricultural University, No. 2, Yuanmingyuan West Road, Haidian District, Beijing 100193, China; (H.X.); (Y.J.); (J.L.); (H.D.); (H.D.); (Y.Z.); (J.G.)
| | - Xiaobo Zheng
- College of Veterinary Medicine, Southwest University, No. 160, Xueyuan Road, Rongchang District, Chongqing 402460, China; (X.Z.); (J.T.); (X.F.); (H.Z.)
| | - Haodi Dong
- College of Veterinary Medicine, China Agricultural University, No. 2, Yuanmingyuan West Road, Haidian District, Beijing 100193, China; (H.X.); (Y.J.); (J.L.); (H.D.); (H.D.); (Y.Z.); (J.G.)
| | - Hongxiu Diao
- College of Veterinary Medicine, China Agricultural University, No. 2, Yuanmingyuan West Road, Haidian District, Beijing 100193, China; (H.X.); (Y.J.); (J.L.); (H.D.); (H.D.); (Y.Z.); (J.G.)
| | - Ying Zhao
- College of Veterinary Medicine, China Agricultural University, No. 2, Yuanmingyuan West Road, Haidian District, Beijing 100193, China; (H.X.); (Y.J.); (J.L.); (H.D.); (H.D.); (Y.Z.); (J.G.)
| | - Jiafeng Gao
- College of Veterinary Medicine, China Agricultural University, No. 2, Yuanmingyuan West Road, Haidian District, Beijing 100193, China; (H.X.); (Y.J.); (J.L.); (H.D.); (H.D.); (Y.Z.); (J.G.)
| | - Jing Tang
- College of Veterinary Medicine, Southwest University, No. 160, Xueyuan Road, Rongchang District, Chongqing 402460, China; (X.Z.); (J.T.); (X.F.); (H.Z.)
| | - Xueqian Feng
- College of Veterinary Medicine, Southwest University, No. 160, Xueyuan Road, Rongchang District, Chongqing 402460, China; (X.Z.); (J.T.); (X.F.); (H.Z.)
| | - Danielle Micceri
- Long Island Veterinary Specialists, Plainview, NY 11803, USA; (J.S.S.); (D.M.)
| | - Haoran Zeng
- College of Veterinary Medicine, Southwest University, No. 160, Xueyuan Road, Rongchang District, Chongqing 402460, China; (X.Z.); (J.T.); (X.F.); (H.Z.)
| | - Degui Lin
- College of Veterinary Medicine, China Agricultural University, No. 2, Yuanmingyuan West Road, Haidian District, Beijing 100193, China; (H.X.); (Y.J.); (J.L.); (H.D.); (H.D.); (Y.Z.); (J.G.)
- Correspondence:
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12
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Characterization of Cryopreserved Canine Amniotic Membrane. MEMBRANES 2021; 11:membranes11110824. [PMID: 34832052 PMCID: PMC8624976 DOI: 10.3390/membranes11110824] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/23/2021] [Accepted: 10/25/2021] [Indexed: 12/12/2022]
Abstract
Amniotic membrane is an effective corneal reconstruction material in veterinary surgery. Cryopreserved amniotic membrane is widely used in practice. Properties of cryopreserved canine amniotic membranes are currently not well studied. This study aimed to compare three properties between canine amniotic membranes cryopreserved for 7 days and 30 days, including tensile strength, transparency, and cell viability. After their respective cryopreservation time, stress-strain curves of the cryopreserved membranes' tensile strength were assessed using a universal testing machine. Both groups produced J-shaped stress-strain curves with statistically comparable parameters, including maximum stress, strain, and Young's modulus. The percentage of cell viability was observed by trypan blue staining under a light microscope. Membrane transparency was tested with a spectrophotometer. Transparency tests showed high levels of light transmission and low haze, with no statistical difference between groups. Cell viability was statistically lower in the 30-day cryopreserved group. Tensile strength and transparency of cryopreserved CAM were not significantly impeded for up to 30 days. For CAM to be used as an alternative corneal transplant material in veterinary and regenerative medicine, further research on cell biology, biomechanical properties of the membrane, and cell viability should be conducted.
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13
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Michel J, Vigan M, Douet JY. Autologous lamellar keratoplasty for the treatment of feline corneal sequestrum: A retrospective study of 35 eyes (2012-2020). Vet Ophthalmol 2021; 24:491-502. [PMID: 34480401 DOI: 10.1111/vop.12930] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 08/12/2021] [Accepted: 08/23/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To evaluate the use of autologous lamellar keratoplasty for the treatment of feline corneal sequestrum (FCS). PROCEDURE The medical records of cats diagnosed with FCS that underwent autologous lamellar keratoplasty between 2012 and 2020 with a minimum of 2 months of follow-up were reviewed. After keratectomy of FCS, a button adjacent to the corneal limbus was harvested on the same eye and sutured to the recipient bed. A nictitating membrane flap was left in place until the first recheck except for one patient. Postoperative treatment with topical and systemic antibiotics and systemic nonsteroidal anti-inflammatory medications was prescribed. Follow-up examinations were carried out 2 weeks, 1 month and 2 months post-operatively and consisted of a complete ophthalmic examination. RESULTS A total of 35 cats (35 eyes) were included. The median follow-up time was 3.2 months (range, 2-59 months). Brachycephalic cats were overrepresented (85.7%). The mean graft size was 6.5 mm (range, 6-9 mm). Minor complications consisting of melting and partial integration of the graft occurred in 2/35 eyes (5.7%). Recurrence was observed in 1/35 eyes (2.9%) and was managed by a superficial keratectomy. A good visual outcome was achieved in all eyes, and a faint or mild corneal opacification occurred in 15/35 (42.9%). CONCLUSIONS Autologous lamellar keratoplasty is an effective treatment for FCS, providing good tectonic support to the affected cornea and resulting in good visual and cosmetic outcomes. These results should be verified in future prospective studies that include a larger number of cases and longer-term follow-up.
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Affiliation(s)
- Julien Michel
- Clinique Vétérinaire VPLUS, Saint-Germain-en-Laye, France
| | - Marie Vigan
- Unité de Recherche Clinique Paris Saclay, Hôpital Ambroise Paré, Boulogne-Billancourt, France
| | - Jean-Yves Douet
- Small Animal Clinic, ENVT, Université de Toulouse, Toulouse, France.,IHAP, INRAE, ENVT, Université de Toulouse, Toulouse, France
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14
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Santillo D, Mathieson I, Corsi F, Göllner R, Guandalini A. The use of acellular porcine corneal stroma xenograft (BioCorneaVet ™ ) for the treatment of deep stromal and full thickness corneal defects: A retrospective study of 40 cases (2019-2021). Vet Ophthalmol 2021; 24:469-483. [PMID: 34480395 DOI: 10.1111/vop.12927] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/26/2021] [Accepted: 08/23/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To document the effectiveness and outcome of corneal grafting using acellular porcine corneal stroma (APCS) for veterinary use (BioCorneaVet™ ) to restore corneal integrity in dogs. METHODS A review of medical records of patients that underwent keratoplasty with APCS graft to repair deep corneal defects, descemetoceles, and perforations between 2019 and 2021 was carried out. Only animals with intact dazzle reflex, consensual PLR before the surgery and a minimum follow-up of four weeks were considered for the study, with forty dogs (1 eye each) meeting the inclusion criteria. RESULTS Brachycephalic breeds were the most frequently represented, and 20 right eyes and 20 left eyes were affected with 25 perforations, 8 descemetoceles, and 9 deep stromal defects (1 eye had both perforation and descemetocele). Most of the patients had concurrent ocular diseases or had undergone previous surgery on the other eye. Two different thickness of xenograft was used (300 or 450 µm), and the diameter ranged from 3 to 10 mm. Postoperative complications included mild to severe corneal vascularization, partial dehiscence, melting, and glaucoma. Follow-up time ranged from 28 to 797 days (mean: 233 days). Ocular integrity was maintained in 37/40 cases (92.5%), and vision was preserved in 36 cases (90%). CONCLUSION The use of APCS (BioCorneaVet™ ) is an effective surgical treatment for deep stromal defects, descemetocele, and perforations in dogs, providing a good tectonic support and preserving anatomical integrity and vision. The cosmetic appearance was considered good in all the cases and continued to improve with time.
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Affiliation(s)
- Daniele Santillo
- Eye Vet Referral, Sutton Weaver, Cheshire, UK.,Centro Veterinario Specialistico, Roma, Italy
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15
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Lavaud A, Kowalska ME, Voelter K, Pot SA, Rampazzo A. Penetrating Keratoplasty in Dogs using Acellular Porcine Corneal Stroma (BioCorneaVet™): A prospective pilot study of five cases. Vet Ophthalmol 2021; 24:543-553. [PMID: 33774897 DOI: 10.1111/vop.12884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 02/01/2021] [Accepted: 03/15/2021] [Indexed: 01/26/2023]
Abstract
OBJECTIVE This prospective pilot study was conducted to evaluate the outcome of a commercially available corneal stroma substitute, Acellular Porcine Corneal Stroma (APCS), in dogs undergoing penetrating keratoplasty (PK) to restore corneal integrity after having deep ulcers. METHOD Five dogs (1 eye in each dog) underwent a PK using APCS (BioCorneaVet™) as a graft. The surgical procedure and peri- and postoperative treatment were standardized. All cases required a minimum 6 months follow-up. Ease of keratoprosthetic tissue handling, graft survival, anterior chamber stability, corneal opacity, neovascularization and re-epithelialization were noted. Presence of secondary uveitis was investigated. RESULTS BioCorneaVet™ was easy to handle and, at all-time points, provided adequate tectonic support. Graft survival was achieved in all 5 cases. A minimum follow-up period of 10 months was available for the five eyes (22 months maximum). Degree and area of corneal graft opacity progressively improved resulting in minimal to moderate loss of transparency in all cases but one, where it was severe. Neovascularization degree was most severe 0.5-1 month after surgery and fully resolved 4-6 months post-surgery. Re-epithelialization was complete in the majority of grafts in 1 month. Secondary uveitis was not detected at any time in 4 of 5 dogs. CONCLUSION BioCorneaVet™ seems to be an effective graft for PK in the dog. In this case series, APCS was convenient to handle during surgery and provided excellent tectonic support. The material showed good tissue biocompatibility and resulted in the majority of cases in minimal to moderate graft opacity, that ameliorates with time.
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Affiliation(s)
- Arnold Lavaud
- Ophthalmology Unit, Vetsuisse Faculty, Equine Department, University of Zurich, Zurich, Switzerland
| | - Malwina Ewa Kowalska
- Ophthalmology Unit, Vetsuisse Faculty, Equine Department, University of Zurich, Zurich, Switzerland
- Section of Epidemiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Katrin Voelter
- Ophthalmology Unit, Vetsuisse Faculty, Equine Department, University of Zurich, Zurich, Switzerland
| | - Simon A Pot
- Ophthalmology Unit, Vetsuisse Faculty, Equine Department, University of Zurich, Zurich, Switzerland
| | - Antonella Rampazzo
- Ophthalmology Unit, Vetsuisse Faculty, Equine Department, University of Zurich, Zurich, Switzerland
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16
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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: 1] [Impact Index Per Article: 0.3] [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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17
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Hartley C. Outcomes of treatments for keratomalacia in dogs and cats: a systematic review of the published literature including non-randomised controlled and non-controlled studies. J Small Anim Pract 2021; 62:840-849. [PMID: 33934337 DOI: 10.1111/jsap.13326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/14/2021] [Accepted: 02/19/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of this review was to interrogate the evidence base for treatment of keratomalacia in dogs and cats, through examination of the applicable literature. MATERIALS AND METHODS Studies were screened for evidence to answer the following question Which of the treatment options for keratomalacia in dogs and cats offers the best chance of globe survival, the fastest time to resolution with globe survival, and the best visual outcome. The search utilised the PubMed (http://www.pubmed.gov/) and ISI Web of Science (http://wok.mimas.ac.uk/) databases. Databases were searched using the following terms: (keratomalacia OR corneal melt OR corneal malacia) AND (dog OR canine OR canid OR cat OR feline OR felid) AND (treatment OR outcome OR morbidity OR complications). Studies were assessed by one author (CH) and excluded if they related to less than three keratomalacia cases, experimental treatments, in vitro studies, or did not provide information regarding outcome. Studies were classified to a level of evidence according to the system described by the Oxford Centre for EvidenceBased Medicine. RESULTS Eighteen (18) studies were identified as providing information to answer the proposed question, one as level 3, 10 as level 4 and seven as level 5 evidence. Only one study compared two treatments, the remaining were prospective or retrospective case series of a single treatment intervention. Study design was highly variable with respect to population size, followup and outcome assessment, making direct comparison difficult, and metaanalysis was not applied. CLINICAL SIGNIFICANCE Overall, the evidence for improved outcome of one proposed treatment over another proposed treatment for keratomalacia in dogs and/or cats is very weak.
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Affiliation(s)
- C Hartley
- Langford Vets, University of Bristol Veterinary School, Bristol, BS40 5DU, UK
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18
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Tsvetanova A, Powell RM, Tsvetanov KA, Smith KM, Gould DJ. Melting corneal ulcers (keratomalacia) in dogs: A 5-year clinical and microbiological study (2014-2018). Vet Ophthalmol 2021; 24:265-278. [PMID: 33794048 DOI: 10.1111/vop.12885] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 03/15/2021] [Accepted: 03/15/2021] [Indexed: 01/26/2023]
Abstract
OBJECTIVES To identify bacterial microorganisms associated with canine keratomalacia, review their antimicrobial sensitivity, and evaluate clinical outcomes compared to results of microbial culture. METHODS Retrospective analysis of clinical records of dogs diagnosed with a melting corneal ulcer presented to a referral hospital in Hertfordshire, UK between 2014 and 2018. RESULTS One hundred and ten melting corneal ulcers were sampled in 106 dogs. The most common pure bacterial isolate was Pseudomonas aeruginosa (n = 26) followed by β-hemolytic Streptococcus (n = 12). Melting corneal ulcers that cultured coagulase-positive Staphylococcus, coliform bacteria, Pasteurella multocida, Enterococcus, and Streptococcus viridans presented in smaller numbers and were analyzed together (n = 16). Multiple cultures were identified in nine cases (n = 9). Forty-seven cultures yielded no bacterial growth (n = 47). The susceptibility to fluoroquinolones remained high with the exception of β-hemolytic Streptococci. There was no significant difference in the ulcer severity at presentation in regard to the cultured bacteria. Overall, 63 eyes (57%) received surgical grafting in addition to medical treatment. In 14 cases (13%), the progression of corneal melting despite medical ± surgical treatment resulted in enucleation. Fifty-seven percent (8/14) of the enucleated eyes cultured pure Pseudomonas aeruginosa isolates. In contrast, all β-hemolytic Streptococcus-associated ulcers healed. CONCLUSIONS The most common bacterial species associated with canine keratomalacia were Pseudomonas aeruginosa and β-hemolytic Streptococcus. Because of the variation in antibacterial sensitivity between these two species, bacterial culture and sensitivity testing should be performed in all dogs presenting with keratomalacia. Melting corneal ulcers associated with pure Pseudomonas infection were significantly more likely to result in globe loss than melting corneal ulcers associated with other cultures.
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Affiliation(s)
- Agata Tsvetanova
- Davies Veterinary Specialists, Manor Farm Business Park, Hertfordshire, UK
| | | | - Kamen A Tsvetanov
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Kerry M Smith
- Davies Veterinary Specialists, Manor Farm Business Park, Hertfordshire, UK
| | - David J Gould
- Davies Veterinary Specialists, Manor Farm Business Park, Hertfordshire, UK
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19
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Rodriguez EN, Townsend WM, Stiles J. Double drape tectonic patch with cyanoacrylate glue for surgical repair of corneal defects: 8 cases. Vet Ophthalmol 2021; 24:419-424. [PMID: 33616291 DOI: 10.1111/vop.12871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 12/12/2020] [Accepted: 01/27/2021] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To describe the use of a double drape tectonic patch with cyanoacrylate glue technique for the treatment of deep or penetrating corneal defects in cats and dogs. ANIMALS STUDIED Eight client-owned animals of which five were cats and three were dogs. PROCEDURE Eight cases: Four with descemetoceles, three with corneal perforations, and one with a deep stromal ulcer were treated with a double layer of plastic drape material adhered to the cornea with a cyanoacrylate (2-octyl or 2-octyl, N-butyl)-based tissue adhesive. The patch was then covered with a third eyelid flap. RESULTS Seven of the eight eyes healed uneventfully with a median time to healing time of 20 days (range 14-28 days). After healing, the glue patch had loosened and was removed. One eye of one cat developed bacterial keratitis with an iris prolapse adjacent to the patch and was subsequently enucleated. Only two of the eight eyes had increased corneal neovascularization. CONCLUSION Treatment of deep or penetrating corneal defects with a double drape tectonic patch and cyanoacrylate glue is a viable option which may be a faster and less expensive alternative to other globe sparing surgical options.
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Affiliation(s)
- Elena N Rodriguez
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
| | - Wendy M Townsend
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
| | - Jean Stiles
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA
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20
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Steinmetz A, Theyse LF. Treatment of deep corneal ulcers with porcine small intestinal submusosa using a modified surgical technique in dogs. Clin Case Rep 2021; 9:812-817. [PMID: 33598250 PMCID: PMC7869326 DOI: 10.1002/ccr3.3661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/12/2020] [Accepted: 11/25/2020] [Indexed: 01/10/2023] Open
Abstract
Treatment of deep corneal ulcers using small intestinal submucosa (SIS) without corneal sutures in combination with a third eyelid flap seems a promising technical modification. Advantages are a reduction in surgery time and no additional damage of healthy corneal tissue.
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21
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Multari D, Perazzi A, Contiero B, Carobbi B, Bertoldi M, Iacopetti I. Corneal sequestra in cats: 175 eyes from 172 cases (2000-2016). J Small Anim Pract 2021; 62:462-467. [PMID: 33511632 DOI: 10.1111/jsap.13303] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 11/27/2020] [Accepted: 12/29/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To report the clinical outcomes of different surgical treatments used to manage feline corneal sequestra in a large number of cases. MATERIALS AND METHODS Medical records of 172 cats affected by feline corneal sequestra and surgically managed by different techniques were retrospectively evaluated. Signalment, surgical technique, visual outcomes, postoperative corneal clarity and recurrence were evaluated. RESULTS One hundred and seventy-two cats (175 eyes) of different breeds, ages and sex were included in the retrospective case series. The Persian was the most represented breed (123/172; 71.5%), followed by Exotic Shorthair breed (21/172; 12.2%), Domestic shorthair breed (21/172; 12.2%) and a smaller group of other different breeds (7/172). Surgical management included a superficial (84/175 eyes) or deep (91/175 eyes) lamellar keratectomy in association with the following covering techniques (tectonic support and/or protective support): nictitans membrane flap (n=84), conjunctival pedicle graft (n=52), BioSISt graft (n=9), corneoconjunctival transposition (n=7), corneoconjunctival transposition+nictitans membrane flap (n=6), conjunctival free island graft (n=6), BioSISt+conjunctival pedicle graft (n=6), BioSISt+nictitans membrane flap (n=4) and bridge conjunctival graft (n=1). At the end of the retrospective case series, visus was present in all patients and no or mild corneal opacity was detected in 86% (151/175 eyes) of the patients. Sequestra recurred in 20 eyes (20/175; 11.4%) within 2 years. CLINICAL SIGNIFICANCE This paper describes the clinical outcomes of a large number of cases of feline corneal sequestra treated with varying surgical techniques and provides useful insight regarding the prognosis and outcomes of these techniques within feline ophthalmology.
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Affiliation(s)
- D Multari
- CVO Fontane, Centro Veterinario Oculistico, Fontane di Villorba, Treviso, 31020, Italy
| | - A Perazzi
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, Padua, 35122, Italy
| | - B Contiero
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, Padua, 35122, Italy
| | - B Carobbi
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, Padua, 35122, Italy
| | | | - I Iacopetti
- Department of Animal Medicine, Production and Health, University of Padova, Legnaro, Padua, 35122, Italy
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22
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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: 7] [Impact Index Per Article: 1.8] [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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23
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Maini S, Hurley-Bennett K, Dawson C. Case Series Describing the Use of Low-Temperature Vacuum-Dehydrated Amnion (Omnigen) for the Treatment of Corneal Ulcers in Cats and Dogs: 46 Cases (2016-2017). Top Companion Anim Med 2020; 41:100474. [PMID: 32919060 DOI: 10.1016/j.tcam.2020.100474] [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: 11/14/2019] [Revised: 08/26/2020] [Accepted: 09/04/2020] [Indexed: 12/13/2022]
Abstract
Amniotic membrane is widely used in the treatment of ocular surface disorders in human and veterinary patients. Preservation and storage of amnion has proven challenging, prompting the development of new preservation techniques. Omnigen, a novel low-temperature vacuum-dehydrated amnion, is reported to possess enhanced structural properties and biochemical stability in vitro, but its clinical use in veterinary patients is not well described. This study aims to document and describe the varied use of Omnigen for the surgical treatment of corneal ulceration in cats and dogs. A total of 45 patients (46 eyes) were recruited from the clinical record system of the Royal Veterinary College (London) between January 2016 and December 2017. Brachycephalic breeds were over-represented (37/45; 82.2%). Omnigen was used as a standalone graft in 5/46 (10.9%) eyes, as a supplementary graft in 29/46 (63.0%) eyes and as a patch in 12/46 (26.1%) eyes. Graft failure occurred in 10/46 eyes (21.7%). At final examination 43/46 eyes (93.5%) had healed and 31/33 eyes (93.9%) were visual. This study demonstrates the successful use of Omnigen for the surgical treatment of corneal ulceration in cats and dogs. Further studies are needed to clarify its properties and benefits in the clinical field.
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Affiliation(s)
- Serena Maini
- Department of Clinical Science and Services, The Royal Veterinary College, Ophthalmology Service, University of London, North Mymms, Herts, UK.
| | - Kiera Hurley-Bennett
- Department of Clinical Science and Services, The Royal Veterinary College, Ophthalmology Service, University of London, North Mymms, Herts, UK
| | - Charlotte Dawson
- Department of Clinical Science and Services, The Royal Veterinary College, Ophthalmology Service, University of London, North Mymms, Herts, UK
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24
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Lores M, Rakestraw P, De Rijck M, Yarbrough T. Use of autologous fascia lata graft to repair a complex corneal ulcer in a mare. Ir Vet J 2020; 73:7. [PMID: 32391144 PMCID: PMC7201622 DOI: 10.1186/s13620-020-00160-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 04/08/2020] [Indexed: 11/29/2022] Open
Abstract
Background Application of an autogenous fascia lata graft in the treatment of keratomalacia in the horse has not been reported. The present case describes the use of an autologous fascia lata graft to surgically treat a complicated corneal ulcer in a horse. Case presentation A 12-year-old Arabian mare was admitted to Sharjah Equine Hospital with a history of right eye ulcerative keratitis of unknown duration. Following a week of aggressive medical treatment, the condition deteriorated and a keratectomy and pedicle conjunctival graft were performed. A week later, the conjunctival graft partially dehisced and the ulcer continued to degrade. In attempting to preserve the integrity of the globe a second grafting procedure was performed when a segment of fascia lata harvested from the ipsilateral hind leg was grafted onto the corneal lesion. Response to surgery was positive and the mare was discharged from the hospital on Day 31 post diagnosis (17 days after the second surgery) with a comfortable eye. Follow-up12 months later revealed a comfortable but only partially visual eye due to corneal scarring. Conclusion Although the graft actually failed from the point of view of tissue integration, fascia lata appears to be a readily available, effective and affordable autografting material and we believe this technique has potential for short term physical and structural support of severe malacic or other complex corneal ulcers.
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Affiliation(s)
- Marcos Lores
- Sharjah Equine Hospital, P.O. Box 29858, Sharjah, United Arab Emirates
| | - Peter Rakestraw
- Sharjah Equine Hospital, P.O. Box 29858, Sharjah, United Arab Emirates
| | - Mieke De Rijck
- Sharjah Equine Hospital, P.O. Box 29858, Sharjah, United Arab Emirates
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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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26
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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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Martin de Bustamante MG, Good KL, Leonard BC, Hollingsworth SR, Edwards SG, Knickelbein KE, Cooper AE, Thomasy SM, Maggs DJ. Medical management of deep ulcerative keratitis in cats: 13 cases. J Feline Med Surg 2019; 21:387-393. [PMID: 29767565 PMCID: PMC10814642 DOI: 10.1177/1098612x18770514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
CASE SERIES SUMMARY Described are 13 cats diagnosed with deep ulcerative keratitis and successfully managed medically without grafting procedures. Typical treatment involved frequent topical application of serum and antibiotics (usually a fluoroquinolone and a cephalosporin). Seven cats also received systemic antibiotics. Analgesia was achieved using various combinations of topical atropine and systemic buprenorphine, robenacoxib or corticosteroids. Six cats were hospitalized for a median (range) period of 2.5 (1-8) days, typically because of frequent medication administration. Median (range) follow-up time was 41.5 (9-103) days. Median (range) number of recheck examinations was 4 (2-6). Median (range) time to corneal re-epithelialization was 21 (9-103) days. Median (range) topical antibiotic course was 29.5 (16-103) days. Median (range) duration of Elizabethan collar use was 28 (13-73) days. At the time of writing, no further recheck examinations were recommended for 10 cats; median (range) time between initial to final examinations in these cats was 35 (20-103) days. All cats retained the affected globes and were apparently comfortable and visual at the latest recheck examination. RELEVANCE AND NOVEL INFORMATION These cases reveal that aggressive medical management is highly successful in select cats with deep ulcerative keratitis, and can result in a cosmetically acceptable, apparently comfortable and visual globe. However, therapy is intensive with frequent administration of multiple topical and sometimes systemic medications, and requires multiple veterinary visits over many weeks. Referral to a veterinary ophthalmologist for consideration of surgical stabilization is recommended, as not all cases may be amenable to the medical therapy described here.
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Affiliation(s)
| | - Kathryn L Good
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Brian C Leonard
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Steven R Hollingsworth
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Sydney G Edwards
- Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Kelly E Knickelbein
- Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Ann E Cooper
- Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Sara M Thomasy
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - David J Maggs
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA, USA
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28
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Pumphrey SA, Desai SJ, Pizzirani S. Use of cyanoacrylate adhesive in the surgical management of feline corneal sequestrum: 16 cases (2011-2018). Vet Ophthalmol 2019; 22:859-863. [PMID: 30869191 DOI: 10.1111/vop.12663] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 02/22/2019] [Accepted: 02/24/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To evaluate the use of cyanoacrylate adhesive as an adjunct to lamellar keratectomy in cats with corneal sequestrum. METHODS Medical records were reviewed to identify cats with naturally occurring midstromal corneal sequestra treated with lamellar keratectomy and cyanoacrylate adhesive. All cats also had a bandage contact lens placed for postoperative comfort. Data collected included breed, age, sex, and reproductive status of the cat, eye involved, presence or absence of neovascularization at the time of surgery, history of prior sequestra, additional ocular procedures performed, use of neuromuscular blocking agents, procedure time, time to cessation of topical medications, time to recurrence or last follow-up, and complications aside from recurrence. RESULTS Sixteen cats met study criteria, with a median follow-up time of 17.5 months in those without recurrence. Median time to cessation of topical medications was 4 weeks. Fourteen cats (87%) have not experienced recurrence. Other than recurrence in two cats, no significant complications were noted. Aside from purebred status, no commonalities were found between the two cats with recurrence. Neuromuscular blocking agents were not used during surgery in most cases. Median procedure time was 10 minutes. CONCLUSIONS Cyanoacrylate adhesive is an effective and safe alternative to grafting procedures in cats undergoing lamellar keratectomy for treatment of corneal sequestrum. Recurrence rates are comparable to those seen with grafting techniques. Benefits of this approach include decreased anesthesia time, lower procedure costs, and short duration of postoperative treatment.
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Affiliation(s)
- Stephanie A Pumphrey
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts
| | - Sujata J Desai
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts
| | - Stefano Pizzirani
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts
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Costa D, Leiva M, Sanz F, Espejo V, Esteban J, Vergara J, Díaz C, Huguet E, Cairó M, Ríos J, Peña MT. A multicenter retrospective study on cryopreserved amniotic membrane transplantation for the treatment of complicated corneal ulcers in the dog. Vet Ophthalmol 2019; 22:695-702. [DOI: 10.1111/vop.12643] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 11/30/2018] [Accepted: 12/01/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Daniel Costa
- Servei d’Oftalmologia de la Fundació Hospital Clínic Veterinari, Facultat de Veterinària Universitat Autònoma de Barcelona Bellaterra Spain
| | - Marta Leiva
- Servei d’Oftalmologia de la Fundació Hospital Clínic Veterinari, Facultat de Veterinària Universitat Autònoma de Barcelona Bellaterra Spain
- Departament de Medicina i Cirurgia Animals, Facultat de Veterinària Universitat Autònoma de Barcelona Bellaterra Spain
| | | | | | | | | | - Clinio Díaz
- Clínica Ocular Veterinaria Gran Canaria Spain
| | | | - Martí Cairó
- Servei d’Oftalmologia de la Fundació Hospital Clínic Veterinari, Facultat de Veterinària Universitat Autònoma de Barcelona Bellaterra Spain
| | - José Ríos
- Laboratory of Biostatistics & Epidemiology, Facultat de Medicina Universitat Autònoma de Barcelona Bellaterra Spain
- Biostatistics and Medical Statistics Core Facility IDIBAPS, Hospital Clínic Barcelona Spain
| | - Maria Teresa Peña
- Servei d’Oftalmologia de la Fundació Hospital Clínic Veterinari, Facultat de Veterinària Universitat Autònoma de Barcelona Bellaterra Spain
- Departament de Medicina i Cirurgia Animals, Facultat de Veterinària Universitat Autònoma de Barcelona Bellaterra Spain
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A bidirectional corneoconjunctival transposition for the treatment of feline corneal sequestrum. Vet Ophthalmol 2018; 22:192-195. [DOI: 10.1111/vop.12586] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Amorim T, Ribeiro A, Ruiz T, Dower N, Madruga G, Schroder D, Monteiro G, Rodrigues B. Impacto do grau de uveíte em diferentes tipos de úlceras de córneas em cães submetidos ao enxerto pediculado de conjuntiva bulbar - 34 casos. ARQ BRAS MED VET ZOO 2018. [DOI: 10.1590/1678-4162-9290] [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
RESUMO O presente trabalho objetivou avaliar os resultados de 34 olhos submetidos ao enxerto conjuntival pediculado (ECP) em ceratites ulcerativas profundas (n=5), em ceratites ulcerativas com colagenólise (n=2), descemetocele (n=7), perfuração corneal (n=15) e prolapso de íris (n=5). Os impactos do grau de uveíte e da integridade da córnea foram correlacionados com presença e ausência de visão por tabelas de contingência. Raças braquicefálicas foram acometidas em 91,11% dos casos. O número de córneas consideradas perfuradas [20/34 (58,82%)] foi maior que o de córneas íntegras [14/34 (41,17%)]. Ao 50º dia de pós-operatório, o número de olhos visuais que apresentavam córneas íntegras previamente às cirurgias (n=13) não diferiu significativamente dos olhos com córneas perfuradas (n=12) (P=0,05). Avaliações relativas ao grau de uveíte, revelaram que a metade dos casos foi considerada severa [17/34 (50%)] e na outra metade as uveítes foram consideradas discretas. Dos 17 casos que apresentaram uveíte severa, oito recuperaram a visão. Já nos 17 olhos onde a uveíte foi considerada leve, 15 mantiveram a visão ao final do período de avaliação. Apesar de a integridade da córnea não se correlacionar com a severidade da uveíte (P=0,48), constatou-se que o número de olhos visuais com uveíte discreta foi significativamente maior que os olhos com uveíte severa (P=0,006). Neste estudo, a taxa geral de sucesso visual após ECP foi de 73,52% e a integridade da córnea não exerceu impacto significativo sobre a manutenção da visão. Todavia, olhos acometidos por uveítes severas apresentaram menor chance de recuperar a visão.
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Affiliation(s)
| | | | - T. Ruiz
- Universidade Federal de Mato Grosso, Brazil
| | | | - G. Madruga
- Universidade Federal de Mato Grosso, Brazil
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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 2016; 19:710-716. [PMID: 27107040 DOI: 10.1177/1098612x16645144] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [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
- 1 Ophthalmology Department, Small Animal Specialist Hospital, North Ryde, Australia
| | - Joanna D White
- 2 Internal Medicine Department, Small Animal Specialist Hospital, North Ryde, Australia
| | - Francis M Billson
- 1 Ophthalmology Department, Small Animal Specialist Hospital, North Ryde, Australia
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Balland O, Poinsard AS, Famose F, Goulle F, Isard PF, Mathieson I, Dulaurent T. Use of a porcine urinary bladder acellular matrix for corneal reconstruction in dogs and cats. Vet Ophthalmol 2015; 19:454-463. [DOI: 10.1111/vop.12326] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Olivier Balland
- Centre Hospitalier Vétérinaire; 95 rue des Mazurots Ludres 54710 France
| | | | - Frank Famose
- Clinique vétérinaire des Acacias; 42 Avenue Lucien-Servanty Blagnac 31700 France
| | - Frédéric Goulle
- Clinique Vétérinaire; Parc d'activité Mermoz; 19 Avenue de la forêt Eysines 33320 France
| | - Pierre-François Isard
- Centre Hospitalier Vétérinaire; 275 route Impériale Saint-Martin Bellevue 74370 France
| | - Iona Mathieson
- Eyevet Referrals; 41-43 Halton Station Road Sutton Weaver Cheshire WA7 3DN United Kingdom
| | - Thomas Dulaurent
- Centre Hospitalier Vétérinaire; 275 route Impériale Saint-Martin Bellevue 74370 France
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34
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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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Dorbandt DM, Moore PA, Myrna KE. Outcome of conjunctival flap repair for corneal defects with and without an acellular submucosa implant in 73 canine eyes. Vet Ophthalmol 2014; 18:116-22. [PMID: 25047064 DOI: 10.1111/vop.12193] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To report and compare the success rate of a conjunctival pedicle flap (CPF) alone vs. a CPF with an underlying acellular submucosa implant for the repair of deep or perforating corneal wounds in dogs. PROCEDURES Records of 69 dogs (73 eyes) receiving a CPF with or without an acellular submucosa implant between 2004 and 2012 were reviewed. Successful outcome was defined as a comfortable eye with vision at the last post-operative evaluation. Age, breed, underlying corneal disease, surgical time, lesion characteristics, topical therapies, and postoperative complications were investigated. RESULTS Groups consisted of dogs that had a CPF alone (n = 37) and dogs that had a CPF plus an acellular submucosa implant (n = 36). Age, lesion size, surgical time, and time to discontinuation of topical anti-proteolytic medications was not significant between groups. Topical antibiotic use was terminated 13 days sooner (P ≤ 0.01) in dogs with an acellular submucosa implant. The combined success rate of all corneal wounds was 93% with success rate of corneal perforations, descemetoceles, and deep stromal wounds being 89%, 95%, and 100%, respectively. There was no difference in overall success rate between groups. Increasing age was associated with a negative outcome (P ≤ 0.01). Lesion size, presence of a corneal perforation, and concurrent keratoconjunctivitis sicca was not associated with a negative outcome. CONCLUSIONS A comparable success rate is achieved for deep or perforating corneal wounds stabilized with a CPF alone vs. a CPF plus acellular submucosa. Glaucoma, persistent uveitis, and cataract formation were not reported as post-operative complications in this study population.
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Affiliation(s)
- Daniel M Dorbandt
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, 501 D.W. Brooks Drive, Athens, GA, 30602, USA
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