Deep corneal ulcer surgery in 18 dogs with and without ACell grafts

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 ACellwere 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 ACellgraft. 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 ACelloccurred 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 ACellcan be utilized for corneal ulcer repair in dogs.