Diamond burr debridement vs. grid keratotomy in canine SCCED with scanning electron microscopy diamond burr tip analysis.

Abstract

OBJECTIVES: (i) Compare the outcome of canine SCCED treated with grid keratotomy (GK) or diamond burr debridement (DBD); (ii) Serially evaluate morphologic and elemental composition changes to diamond burr tips. ANIMALS STUDIED: A total of 91 eyes of 88 canine SCCED patients treated at the University of Missouri (2005-2015); 75 fresh cadaver porcine globes. PROCEDURES: (i) Medical records were reviewed retrospectively. Data were analyzed for age, sex, breed, procedure performed, eye(s) on which the procedure was performed, time to healing after a single surgical procedure, performance of a second surgical procedure, contact lens placement, and postprocedural complications. (ii) Three naïve 3.5-mm medium grit burr tips were analyzed using scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS). DBD was performed for 120 s on 8-mm porcine corneal stroma using the Algerbrush. Manufacturer-recommended cleaning protocols were followed. SEM and EDS analyses were performed in triplicate after 10, 25, and 50 DBD, cleaning, and sterilization cycles. RESULTS: There was no statistically significant difference in healing between DBD and GK groups (P = 0.50). No diamond particle damage after 10, 25, or 50 DBDs was detected. SEM secondary electron imaging and backscatter electron imaging after repeated uses demonstrated a build-up of contamination composed of carbon, sulfur, and calcium on burr tips. CONCLUSIONS: Both DBD and GK are effective treatment options for canine SCCED. Although complications are rare after DBD, build-up of contaminants may be a contributing factor. Additional cleaning and sterilization protocols are being investigated.