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

Abstract

To document a case series using corneoconjunctival transposition (CCT) surgery with and without bioscaffolding matrix (ACell® ) to repair deep corneal ulcers and perforations in dogs. Eighteen dogs of various breeds that presented with deep or perforating corneal ulcers. Corneoconjunctival transposition grafts with or without ACell® were sutured using a simple interrupted 8-0 or 9-0 polyglactin 910 pattern. A total of eighteen dogs (19 eyes) were diagnosed with deep corneal ulcers (n=7) and perforating corneal ulcers (n=12). A CCT was performed in all eyes, with ten of them additionally receiving an ACell® graft. The majority of lesions were located axially in 14/19 (81%) eyes. Grafts were harvested from dorsal (n=8), temporal (n=5), ventral (n=4), or nasal (n=2) quadrants. Brachycephalic breeds (13/18) were over-represented. Keratoconjunctivitis sicca was present in 10/19 eyes (52.6%). Bacterial isolates were cultured from 8/19 eyes. Post-operative therapy included topical antibiotics, plasma, cycloplegics, oral antibiotics, and oral nonsteroidal anti-inflammatory drugs. CCT integration with and without ACell® occurred at a median of 20days (range 7-38days) post-operatively with no significant difference between groups. Median follow-up time was 188days.Short-term post-operative complications included granulation tissue formation (19/19), corneal edema (4/19), graft retraction (4/19), and anterior synechia (1/19). Long-term complications in 14 eyes with follow-up >30days included superficial corneal pigmentation (6/14) and epithelial inclusion cysts (5/14). Two eyes were nonvisual at last follow-up due to cataract formation. Corneoconjunctival transposition with ACell® can be utilized for corneal ulcer repair in dogs.