Corneoconjunctival transposition for the treatment of feline corneal sequestra: a retrospective study of 17 cases (1990-1998) (original) (raw)
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Veterinary Ophthalmology, 2014
Objective To determine the clinical outcome of corneal grafting for the treatment of feline corneal sequestrum (FCS). Animal studied Domestic cats. Procedures A review of the medical records of cats that underwent keratoplasty as a treatment of FCS at the VTH-UAB, from 2002 to 2012, was carried out. Results Thirteen cats (18 eyes) of different breed, age, and gender were included. Persian cats were overrepresented (12/13;92%). There were nine males and four females, of a mean age of 3.4 years (0.7-7.1). Ipsilateral chronic corneal ulceration was reported as the most common concurrent ocular disease (6/18;33%). Keratoplasty was performed bilaterally in 5 cats (5/13;38%) and unilaterally in 8 (8/13;62%). Lamellar keratoplasty was performed in 17 eyes (17/18;95%) and full-thickness keratoplasty in 1 (1/18;5%). Mean graft size was 8.3 mm (4-11.5). Fresh homologous graft was performed in 2 eyes (2/18;11%) and frozen graft in 16 (16/18;89%). Of the latter group, homologous graft was performed in 6 eyes (6/16;37.5%) and heterologous in 10 (10/16;62.5%). In all the cats, postoperative treatment included topical antibiotics, corticosteroids, cycloplegics, and 0.2% cyclosporine A. Median follow-up time was 18.2 months, and main postoperative complications were diffuse mild epithelial pigment formation (2/18;11%), graft malacia (1/18;5%), and sequestrum recurrence (1/18;5%). Mean epithelial healing time was 19.2 days. Good visual outcome was achieved in all the eyes (100%), the majority of them having faint or mild corneal opacity (15/18;83%). Conclusions Keratoplasty is an effective surgical treatment for FCS. The donor tissue provides excellent tectonic support to the affected corneas, with good visual and cosmetic outcome.
Veterinary Ophthalmology, 2020
Objective: To 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 studied: One hundred client-owned dogs with deep stromal ulcers, descemetoceles, or full-thickness corneal defects. Methods: Medical 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. Results: There 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). Conclusions: Corneoconjunctival 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.
Veterinary Ophthalmology, 2020
PurposeTo report surgical and corneal clarity scores (CCSs) of corneo‐limbo‐conjunctival transpositions (CLCTs) in a large number of canine cases.MethodsRetrospective review of records that underwent CLCT to repair deep ulcers or perforations between 2002 and 2018. Signalment, concurrent eye disease, additional procedures, pathogenesis, medication, graft orientation, follow‐up, and CCSs were recorded.Results418 eyes of 399 dogs were included. Brachycephalics were most commonly affected, comprising 325/418 (77.75%) of the eyes. The most commonly affected breeds were Pugs, Shih Tzus, Cavalier King Charles Spaniels, and French Bulldogs, with 116/418 (27.75%), 64/418 (15.31%), 34/418 (8.13%), and 34/418 (8.13%) ulcerated eyes, respectively. Mean age at surgery was 5.5 years (range 59 days‐17.7 years), and median follow‐up time was 100 days (range 3 days‐7.64 years). The most common etiopathogenesis was spontaneous ulceration in 205/418 eyes (49.04%) of which 191 (93.17%) occurred in bra...
Veterinary Ophthalmology, 2019
Feline corneal sequestrum is a well-characterized but poorly understood disease entity. Sequestra may cause significant discomfort and in some cases lead to globe rupture and loss of the eye. Surgical management is generally required for resolution, but consensus does not exist regarding choice of surgical procedure. Furthermore, sequestra vary greatly in size and depth, suggesting that a single surgical option may not suit all patients. Interventions evaluated in the literature for feline corneal sequestrum include lamellar or full-thickness keratectomy with or without a grafting procedure. 1-14 Surgical time, procedure cost, duration of postoperative treatment, and final corneal clarity can vary significantly depending on the procedure performed. The intent of this study is to report on
2016
Amniotic membrane transplantation is used in both human and veterinary ophthalmology for ocular surface reconstruction after certain ocular diseases in order to regain corneal transparency and to improve visual outcome. Feline corneal sequestrum is a disease unique to the cat, characterized by the presence of an area of corneal necrosis, brown coloured, sometimes accompanied by vascularization and edema, usually located in the center of the cornea. Depending on the stage of the disease, treatment can be medical or surgical. This pilot study aims to evaluate the clinical outcome after lamellar keratectomy and amniotic membrane transplantation in cases of feline corneal sequestrum. The study was conducted in the Opthalmology Department of the Faculty of Veterinary Medicine in Bucharest and in Oftalmovet Private Practice in Valencia for a period of two years. During this time, six cats with corneal sequestrum underwent superficial keratectomy associated with human amniotic membrane tra...
Ciência Rural, 2001
Corneal sequestration is a disease unique to domestic cats, clinically characterized by chronicity; signs of ocular pain with the development of a dark brown to black, opaque, oval, paracentral or central corneal plaque. The purpose of this review article was to approach and discuss about the etiology, clinical manifestations, diagnosis, and treatment of the corneal sequestrum.
Feline corneal sequestrum: laboratory analysis of ocular samples from 12 cats
Veterinary Ophthalmology, 2004
Feline corneal sequestrum is a common ocular condition typified by brown to black discoloration of the cornea. The nature of the discoloration has not been identified. The purpose of this study was to perform a laboratory investigation of ocular samples from 12 clinical cases of feline corneal sequestrum in an attempt to characterize the nature of the discoloration. The 12 cases were referred to the Ophthalmology Unit at the Animal Health Trust between April and September 2000, and were also part of a clinical review of 64 cases of feline corneal sequestrum described separately. Five laboratory techniques that are routinely performed at the Biomaterials Unit, Aston University were employed for analysis of the ocular samples. Ocular material included corneal sequestrum, tear samples, meibomian gland secretions, and bandage contact lenses from the 12 clinical cases. High-performance liquid chromatography data showed that total tear lipid in affected eyes was significantly lower than in control eyes ( P = 0.016); total tear lipid in affected eyes was lower than in the unaffected, contralateral eyes of the same cat but the difference was not significant ( P = 0.29). The presence of an unknown lipid class was observed in tears and meibomian secretions of affected, contralateral and control eyes. Scanning electron microscopy showed that the discoloration in affected corneas was not due to the presence of iron. Fluorescence spectroscopic analysis of sequestra, unaffected corneas and contact lenses (from affected and contralateral/unaffected eyes) showed that lipid and protein were present but did not play an important role in sequestra. Ultraviolet-visible light absorbance spectroscopy revealed a peak at 385 nm in unaffected corneas that was absent in sequestra and the difference was significant ( P < 0.0001); this peak may be a characteristic feature of the normal feline cornea. The absorbance spectra displayed a peak at 280 nm in two sequestra suggesting that chromophore groups (e.g. melanin) were present. Optical microscopy performed on 10 sequestra revealed the presence of particles, which were consistent with the appearance of melanin particles, providing laboratory evidence that characterized the nature of the discoloration as melanin for the first time.
Ultrastructural findings in feline corneal sequestra
Veterinary Ophthalmology, 2005
Objectives (1) To describe the ultrastructural features of corneal sequestra in cats; and (2) to enhance our understanding regarding the pathogenesis of feline corneal sequestration. Methods Nine corneal sequestra were harvested via keratectomy from globes of nine cats. The sequestra were routinely fixed then postfixed for high resolution light and transmission electron microscopy (HR-LM and TEM, respectively). The tissues were embedded in Epon/Araldite. Sections of 0.5-µ m thickness were cut and stained with 1% toluidine blue in 1% sodium tetraborate solution for HR-LM. Ultrathin sections were collected on copper grids and stained with uranyl acetate and Sato's lead stain for TEM. Ultrathin sections were examined and the images were captured on an Advantage HR CCD camera using a Hitachi 7500 electron microscope operated at 80 kV. Two healthy corneas from two cats were harvested immediately following euthanasia. These corneal tissues (control samples) were processed in the same manner as the corneal sequestra for HR-LM and TEM. A portion of each sequestrum was also submitted for polymerase chain reaction (PCR) testing for infectious agents including feline herpesvirus-1 (FHV-1), Toxoplasma gondii , Chlamydophila felis and Mycoplasma spp. Results Ultrastructure of healthy corneal tissues revealed basal corneal epithelial cells aligned adjacent to a thin acellular layer similar to Bowman's layer with underlying tightly packed, regularly arranged, collagen fibrils oriented in different planes. Keratocytes were elongated and had long and irregularly shaped nuclei, and cytoplasm contained rough endoplasmic reticulum and abundant membrane-bound vesicles. In contrast, corneal sequestra contained varying amounts of an amorphous, electron-dense substance, continuous with intact basal epithelial basement membranes peripherally, and overlying corneal ulceration and loosely packed collagen fibrils. Remnants of necrotic keratocytes were seen in spaces between disarranged collagen layers. In all samples, occasional keratocytes exhibited morphology indicative of apoptosis including clumping and margination of chromatin, and shrunken cytoplasm. Varying degrees of inflammation were noted on HR-LM and TEM of affected corneas including peri-and intralesional neutrophils, lymphocytes, plasma cells, and macrophages. Corneal sequestra were FHV-1-positive ( n = 3), FHV-1-and T. gondii -positive ( n = 1), T. gondii -positive ( n = 3), or negative for DNA of these infectious agents ( n = 2) using PCR. All corneal sequestra were negative for DNA of Chlamydophila felis and Mycoplasma spp. using PCR. Conclusions Apoptosis may play a role in the pathogenesis of feline corneal sequestration independent of the presence of DNA of these infectious organisms. Prospective clinical studies are warranted to further understand the significance of T. gondii in relation to feline corneal sequestration.
2022
The presented study was designed to compare the clinical features and the surgical outcomes of three techniques, such as the conjunctival pedicle fl ap (CPF), platelet-rich fibrin membrane graft (PRFMG), and nictitating membrane fl ap (NMF) applied after lamellar keratectomy to treat corneal sequestrum in cats. The postsurgical outcomes, complications, and recurrence rate of the lesions in 31 eyes of a total of 30 cats of diff erent ages, breeds, and gender diagnosed with corneal necrosis were evaluated in the study. After partial keratectomy, patients were divided into three groups, each containing ten animals. Perioperative findings of all cases that underwent CPF, PRFMG, and NMF applications, including postsurgical complications, were evaluated. All patients were regularly monitored. Advantages and disadvantages were noted for all three techniques during and after the surgery. Despite long-term medical treatment with CPF (3-4 months), varying degrees of permanent fibrosis partial...
Diagnosis, Medical and Operative Treatments of Lens Diseases in Cats and Dogs
Erciyes Üniversitesi Veteriner Fakültesi Dergisi, 2021
Lens diseases are common causes of blindness. These diseases, which cause vision loss if not diagnosed and treated early, are among the most important eye problems that negatively affect the living standards of cats and dogs. The aim of this study was to determine the distribution of lens diseases among cats and dogs according to breed, age and etiological causes, determine the conditions affecting the diagnosis and treatment of these diseases, report the success of the treatment, and present the data. The study material consisted of a total of 45 patients, 17 cats and 28 dogs of different ages, sexes and breeds brought to Istanbul University-Cerrahpaşa, Faculty of Veterinary Medicine, Department of Surgery and diagnosed with lens disease. After an anamnesis, signalement, a detailed eye examination, the diagnosis of the disease and its relationship with other ocular and systemic diseases were investigated, treatment procedures were determined and performed. Postoperative results of the surgical technique and success rates were determined. Patients were checked at regular intervals after treatment.