Amniotic membrane surgery for complicated dog corneal ulcers

Abstract

OBJECTIVE: To describe the surgical technique and outcome of amniotic membrane transplantation (AMT) for treatment of complicated corneal ulcers in dogs. ANIMALS STUDIED: One hundred and eleven dogs. PROCEDURE: Medical records (2010-2017) were reviewed to identify canine patients that underwent AMT for the treatment of complicated corneal ulcers. Quantitative and ordinal variables were analyzed using Mann-Whitney U test and Fisher's Exact test. RESULTS: Brachycephalic breeds were overrepresented (74/111; 66.6%). Three dogs were bilaterally affected. Fifty-one had melting ulcers (51/114; 44.7%), 33 stromal ulcers (33/63; 52.4%), 17 descemetoceles (17/63; 27%), and 13 perforations (13/63;20.6%). Mean defect size was 6.2&#xa0;mm (2-18&#xa0;mm). Human (32/114; 28.1%) or bovine (82/114; 71.9%) (AmnioVet(R)) cryopreserved amniotic membranes were used. Monolayer (31/114; 27.2%), bilayer (44/114; 38.6%) or multilayer technique (39/114; 34.2%) was performed, being anchored to the limbus (52/114; 45.6%), to the defect (48/114; 42.1%) or both (14/114; 12.3%). Mean epithelial healing and follow-up times were 25.6&#xa0;days (15-45) and 98.7&#xa0;days (21-400), respectively. Most common postsurgical complications included pigmentation (10/114; 8.8%) and graft failure (5/114; 4.4%). Depth and size of corneal lesions, human amniotic membrane (AM) and concurrent ocular diseases were associated with more complications (P&#xa0;<&#xa0;0.05). Good cosmetic and visual outcomes were achieved in 99.1% (113/114) and 97.4% (111/114) of cases, respectively. Zero to low graft opacity was seen in 23.9% of the eyes (27/113), mild to moderate in 64.6% (73/113) and complete in 11.5% (13/113). CONCLUSIONS: Cryopreserved AMT is an effective surgical technique for the treatment of complicated corneal ulcers in the dog, with highly satisfactory visual and cosmetic outcomes.