Penetrating keratoplasty for treatment of corneal abscesses in horses – case report

Zita Makra,Gábor Bodó,Imre Biksi

doi:10.2754/avb201382030303

Abstract

This case report describes the surgical technique and outcome of allograft transplantation to treat full thickness corneal abscesses in three horses. In all three cases penetrating keratoplasty was performed. Each affected eye had an abscess within the corneal stroma. An initial full thickness circular corneal incision was made around the lesion. After excision of the stromal abscess the created defect was replaced with a larger diameter full thickness donor graft and the initial corneal incision was repaired. All of the horses that underwent penetrating keratoplasty procedure healed with a scar at the graft site and remained visual. Penetrating keratoplasty is an effective technique for surgical removal of medically nonresponsive full thickness stromal abscess in horses and results in a visual and cosmetically acceptable globe. The advantages of this technique compared to medical therapy are that there is less scarring, shorter healing times and less damage of the globe because of the concurrent uveitis. To the authors’ knowledge, clinical experience with penetrating keratoplasty in horses has not been reported in Europe so far.

Highlights

Full thickness corneal abscess is a real challenge for the treating veterinarian and needs surgical repair
The surgery time for Penetrating keratoplasty (PK) was 100, 70 and 90 min in case 1, 2 and 3, respectively, with an average of 86 min, which was similar to the cases (91 min) described in a previous study (Whittaker 1997)
Either fresh or frozen donor cornea can be utilized in PKs

Summary

Introduction

Full thickness corneal abscess is a real challenge for the treating veterinarian and needs surgical repair. Penetrating keratoplasty (PK) has been described in the horse for full thickness stromal abscess (SA) (Andrew 2000; Plummer 2008; Brooks 2008, 2010). Corneal transplantation for treatment of severe inflammatory keratopathies has been performed successfully in horses at the University of Florida since 1993 (Brooks 2008). Causative agents cannot be isolated in all cases, the majority of the cases are caused by fungus, gram-positive cocci, or gram-negative rods. It is a yellow-white stromal infiltrate of variable size and depth with corneal oedema, neovascularization and iridocyclitis (Hamilton 1994). Fungal keratitis and SA are not rare in European horses, PK surgeries have not been described in complicated clinical cases so far in Europe.

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