Use of a porcine urinary bladder acellular matrix appears to be effective in the surgical management of deep corneal ulcers and feline corneal sequestra.
Two young dogs were presented for the evaluation of an abnormally haired appearance of both eyes since adoption. In one dog, the lesions were symmetrical and appeared as disorganized skin tissue located on the cutaneous aspect of the lateral portion of both lower eyelids, and continuing to the palpebral and the bulbar conjunctiva, thus forming continuous lesions. In the other dog, a similar lesion was present in the right eye (OD), but the lesion of the left eye (OS) was of discontinuous, disorganized skin tissue located midway on the lower eyelid and on the lateral bulbar conjunctiva. The lesions were surgically removed and routinely processed for histopathological analysis. Definitive diagnosis was conjunctivo-palpebral dermoids for each dog. Dermoids are usually considered to be choristoma (normal tissue in an abnormal location) when they are located on the ocular surface (cornea and/or conjunctiva) and as hamartoma when located on the palpebral skin. The lesion presentation in these two dogs reveals that names of "choristoma" alone or "hamartoma" alone are not accurate to depict the continuous, composite, conjunctivo-palpebral dermoids. These cases suggest that choristoma and hamartoma might develop subsequently from the same abnormal event during the embryonic development, which means that the lesion location might be the only difference between the two terms.
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.
This tarsomarginal grafting technique has yielded encouraging results in dogs. This technique can fill large lid defects with a physiologic lid margin but is shortening the stretched lid fissure length.
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