Corneoconjunctival transposition for the treatment of deep stromal to full‐thickness corneal defects in dogs: A multicentric retrospective study of 100 cases (2012‐2018)

Abstract

ObjectiveTo describe and evaluate the use of corneoconjunctival transposition (CTT) as a surgical treatment for canine deep stromal ulcers, descemetoceles, and full‐thickness corneal defects and to determine its efficacy in preserving corneal graft transparency and vision.Animals studiedOne hundred client‐owned dogs with deep stromal ulcers, descemetoceles, or full‐thickness corneal defects.MethodsMedical records of canine patients that underwent CCT, from 2012 to 2018, were reviewed. Only, patients with preoperative positive consensual pupillary light and dazzle reflexes were included.ResultsThere were 59 males and 41 females, from 0.3 to 17 years. Brachycephalic breeds were overrepresented (65%). All patients were unilaterally affected, with 16 deep stromal ulcers, 33 descemetoceles, and 51 corneal perforations, of a median (range) size of 4 (2‐8) mm. The central cornea was affected in the majority of cases (57%), and euryblepharon and keratoconjunctivitis sicca were the most common concurrent ocular diseases (42% and 40%, respectively). The graft was most frequently harvested from dorsal (67%), and 9/0 absorbable suture material was used. Intraoperative and postoperative complications were seen in 7 and 21 cases, respectively. Mean follow‐up time was 107.8 days. Vision was preserved in 96% patients, with 62% showing faint to mild opacification. Among the statistically analyzed variables, euryblepharon and pigmentary keratitis were found to be significantly associated with greater corneal graft opacification (P = .040 and P = .028, respectively).ConclusionsCorneoconjunctival transposition is an effective surgical treatment for deep stromal, descemetocele, and full‐thickness corneal defects in dogs, achieving a highly satisfactory degree of corneal graft transparency and preserving vision.

Corneo‐limbo‐conjunctival transposition to treat deep and perforating corneal ulcers in dogs: A review of 418 eyes and corneal clarity scoring in 111 eyes

“…Multiple corneal reconstructive techniques have been described utilizing conjunctiva, amniotic membrane, corneal tissue, and synthetic or bioengineered materials 3‐21 . The use of lamellar corneal grafting techniques can better preserve corneal transparency when compared to conjunctival pedicle grafting 18,22‐26 . Autologous grafts offer the advantage that they avoid immune‐mediated graft rejection and the need for corneal banking 6,18,22 .…”

Corneoconjunctival transposition with and without ACell®for deep corneal ulcer repair in 18 dogs

“…Gogova et al 27 found that euryblepharon and pigmentary keratitis were directly associated with decreased corneal clarity in post-operative CCT cases. In the present study, chronic post-operative complications resulting in corneal opacification included corneal pigmentation in 6/14 eyes (42.8%) and epithelial inclusion cysts in 5/14 eyes (35.7%).…”

“…The corneoconjunctival transposition (CCT) is a modification of the corneoscleral transposition that uses conjunctiva rather than sclera. 1,[25][26][27][28][29] This surgical technique involves a sliding transposition of adjacent healthy cornea and attached bulbar conjunctiva, which allows for a clearer visual axis compared to other surgical techniques. However, a peripheral opacity may remain from the transposed limbus and conjunctiva.…”

“…The success rate ranges from 89%-93%. 7,11,13 Gogova et al 27 described 100 cases using CCT alone for surgical repair of corneal ulcers and perforations in canine eyes with similar success rates of 100% globe retention and 96% vision retention. One of the challenges they described was harvesting and suturing the graft in perforated eyes.…”

“…[24][25][26] The number of cases reported utilizing a CCT are limited in the dog and, to the authors' knowledge, there are no reports utilizing CCT in combination with ACell ® in canine patients. 23,27 The purpose of this study is to compare the surgical outcomes using corneoconjunctival transposition surgery, with and without bioscaffolding matrix (ACell ® ), to repair deep corneal ulcers and perforations in eighteen dogs.…”