Background: Eyelid coloboma is considered a disease caused by failure in eye development during the first semester of pregnancy. In felines, its prevalence occurs in the upper eyelids, temporal region, and bilaterally. Coloboma, whether to a large or small extent, can lead to keratoconjunctivitis sicca and trichiasis, situations that can give rise to secondary ulcerative keratitis. The only corrective method is blepharoplasty. The current work aims to report the case of corrective surgery for eyelid coloboma in a feline with a successful postoperative period, in order to corroborate the effectiveness of the technique. We also report a finding of persistent pupillary membrane.Case: A 7-month-old male feline, no defined breed, was analyzed with a purulent mucus secretion and signs of discomfort in the right eye. After the ophthalmic screening, the presence of a coloboma was identified, which occupied approximately 50% of the size of the upper eyelid, in the temporal-dorsal region of the right eye. The cat had already undergone an enucleation of the left eye due to a perforation arising from ulcerative keratitis. Together with coloboma, the presence of blepharospasm, trichiasis, keratoconjunctivitis sicca, and secondary ulcerative keratitis were diagnosed. The presence of persistent pupillary membrane was also observed, a rare condition in the feline species. To confirm the ulcer, the fluorescein test was applied and treatment with antibiotic eye drops and lacrimomimetics (tear film replacements) drops was administered until the day of surgery, one week later. Concomitant with the institution of treatment prior to surgery, blood was collected for complementary pre-surgical tests such as blood count and biochemistry, which demonstrated satisfactory results. Corrective surgery was then instituted by the technique of transposing the labial commissure, described in 2010, which consists of replacing the colobomatous tissue with a flap from the oral region. To ensure quality in the postoperative period, the use of the Elizabethan collar, oral antibiotics, analgesics, anti-inflammatory drugs, and cleaning with 0.9% saline solution around the sutures were prescribed. The first return appointment occurred on the day after the operation and further appointments were made weekly for one month. As the animal did not present any complications in the healing process, the spacing between the follow-up appointments was increased. After 2 months, the animal demonstrated a palpebral reflex and a pleasant appearance.Discussion: The results were similar to those described by the author of the technique, as there was no recurrence of hair in contact with the cornea, the flap mucosa became efficient in terms of the quality in lubricating the fibrous tunic, and an appearance acceptable to the owner was achieved. It is also reported that, different from previous studies, the technique was able to correct palpebral coloboma without any complications during the post-surgical process. In all previously published works, some type of setback was reported, such as dehiscence of the suture of the oral region, dehiscence of the transposed suture, superficial necrosis of the flap, deformation of facial folds, excessive graft retraction, and return of trichiasis in the pre-existing medial region. It is inferred, then, that the use of this technique for correction of eyelid coloboma longer than 1/3 should be indicated.
Background: Pseudopterygium, also known as aberrant conjunctival growth, is poorly described in the literature, although it is known that this abnormality is uncommon and affects dwarf rabbits and their crossbreeds. The etiology of this disease is unknown, but there are hypotheses that the conjunctival growth cause may have its origins in immunological factors, inflammation, traumatic conditions, or cartilage dysplasias. Thus, this study reports the treatment efficacy applied in a rabbit, through the continuous use of tracolimus eye drops, after surgical procedure of conjunctival fold resection, as a way of controlling the pseudopterygium in rabbits.Case: This case report discusses the positive results from the surgical and therapeutic conduct of a clinical case attended by the Ophthalmology and Microsurgical Veterinary Service at the Hospital Veterinário Universitário (HVU) of the UFSM. The patient was a male rabbit, sterilized cunicle, approximately 2-year-old, crossed with a dwarf rabbit. The owner's main complaint was the change in the aspect of the left eye, with progressive worsening in the previous four weeks. In the ophthalmological examination, the animal did not present impaired vision or discomfort, however, a vascularized pink membrane was noted, which consisted of a fold of the bulbar conjunctiva, that grew centripetally and covered 90% of the cornea in 360 degrees. The diagnosis was confirmed through visual inspection and the patient's history. The eye alteration had a characteristic aspect, described as proliferation of the bulbar conjunctiva over the cornea, in a centripetal manner and without signs of inflammation. In addition, other ophthalmological alterations were ruled out during the patient's physical and specific examination. The patient was referred for anesthetic evaluation and, in addition, pre-surgical blood tests were performed, which were normal, according to the expected ranges for the species. Subsequently, the animal was submitted to surgical treatment, which consisted of dividing the exuberant conjunctiva, followed by three radial incisions in equal portions. Next, the conjunctival fold was completely incised to the edge of the limbus, without the need of sutures. Anterior lamellar keratectomy was performed on the portion where the membrane was attached to the cornea. For home care, tobramycin-based eye drops (QID, for 7 days) and 0.02% aqueous tacrolimus eye drops (BID - continuous use) were prescribed. The animal was reevaluated 7, 14, 30, 60, 120 and 180 days after surgical correction, and no recurrence of pseudopterygium was observed during the follow-up period. The prognosis of patients with pseudopterygium is reserved, as it is known that the disease may recur after surgical treatment. Therefore, the continuous use of the chosen immunomodulating eye drops was recommended as well as periodic follow-up of the patient.Discussion: In the current study, it was not possible to increase knowledge regarding about the pseudopterygium etiology. Although the condition is not serious, it can cause partial impairment of vision and chronic discomfort. However, the vision field described in the rabbit in this current case remained unchanged, in accordance with other cases described in the literature. Furthermore, no signs of patient discomfort were detected. Some surgical techniques described in the literature for correction of pseudopterygium, shows membrane’s growth recurrence. The use of immunomodulatory drugs is suggested for relapses controlling. In this study, the tracolimus eye drops efficacy was tested, and presented good results in the patient's evaluations for a long period after surgery. The use of immunomodulators is an option for adjuvant topical treatment for controlling pseudopterygium growth, which, associated with corrective surgical treatment, has shown positive results.Keywords: conjunctiva, aberrant, immunomodulator, treatment, bunny.Título: Pseudopterígio em coelho - tratamento com tracolimusDescritores: conjuntiva, aberrante, imunomodulador, tratamento, coelho.
Background: Due to its ocular microflora, the equine species is predisposed to develop mycotic ulcers which, when not properly treated, can lead to the formation of a stromal abscess. A stromal abscess occurs through the introduction of microorganisms into the corneal stroma. During re-epithelialization, the foreign body is encapsulated, thus creating a barrier that protects bacteria or fungi from treatment with antimicrobial medication. This framework can end up resulting in blindness due to chronic iridocyclitis, putting the animal's vision at risk. The current work aims to report a case of corrective surgery for stromal abscess in a mare with the administration of intraoperative intrastromal fluconazole, in order to corroborate the effectiveness of the technique. Case: A 9-year-old mare was evaluated, with the complaint that her right eye was closed and “yellowish” and that she had already been treated with intramuscular injectable anti-inflammatory drugs based on flunexin meglumine (Banamine® - 50 mg) for 15 days, referring to a possible ulcer in the right eye. Ophthalmic screening resulted in a negative direct reflex and no threat response in the right eye. Examination of the conjunctiva showed congestion and chemosis. Examination of the cornea of the right eye was negative for Fluorescein and Green Lissamine tests, and opacity and corneal neovascularization were noted. The final diagnosis was a corneal abscess of probable fungal origin secondary to a keratomycosis. After the consultation, complementary blood and biochemical tests were performed, which showed normal results for the species in question, and treatment was started with eye drops based on atropine 1% (Fagra® - 20 mL), ciprofloxacin antimicrobial eye drops (Ciprovet Colirio® - 5 mL), and antifungal eye drops based on ketoconazole 1% (manipulated), in addition to an intramuscular injectable anti-inflammatory based on flunexin meglumine (Banamine® - 50 mg - 1.1 mg/kg SID) and an intramuscular injectable analgesic based on sodium dipyrone (Febrax® - 0.5 g - 15 mL/animal SID) until the day of surgery, which was booked for 3 days later. The surgical intervention was then instituted by the technique of anterior lamellar keratectomy followed by intrastromal hydration with fluconazole and the forming of a bipedicled flap, in order to remove the necrotic tissue and antigenic stimulation factors, while the conjunctival flap aimed to improve blood supply and protect the injured area, thus favoring local healing. For better postoperative quality for the animal, continuation of the same treatment as prior to surgery was prescribed for a period of 15 days. The return of the animal for the removal of the flap was scheduled for 45 days after surgery, however, due to the COVID-19 pandemic, there was a delay of 135 days. When the animal returned the flap was still stable. A second surgery was instituted for the removal of the flap, during which it was possible to affirm that the cornea had recovered total integrity and partial transparency with only a leukoma in the previous location of the abscess.Discussion: The technique of anterior lamellar keratectomy together with the use of a conjunctiva flap for the treatment of stromal abscess in horses is a known technique that is used routinely, although some cases report the formation of a second infection in the same space. However, there are few reports on the use of intrastromal hydration with antifungal medication adjuvant to the surgical technique, which, as shown in this report, proved to be effective since even with the issue of a delay in removing the conjunctival flap, the eye remained whole and there was no second infection. The use of this technique can therefore be indicated for the treatment of stromal abscess in horses, given the safety that the application of intrastromal antifungal provides.Keywords: azole, abscess, stromal, keratectomy, ophthalmology, equine, mare.Descritores: azol, abscesso, estroma, ceratectomia, oftalmologia, equino, égua.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.