Porcine urinary bladder extracellular matrix grafts (ACell Vet® Corneal Discs) for keratomalacia in 17 equids (2012-2013).

Abstract

To describe the clinical course, outcomes, and complications associated with use of commercially available porcine urinary bladder extracellular matrix (ECM) grafts (ACell Vet(®) Corneal Discs) in equid patients with keratomalacia, and to evaluate the efficacy of ECM grafts as a viable alternative to other biomaterials for corneal grafting in equid patients. Sixteen horses and one donkey (17 eyes) with unilateral keratomalacia severe enough to warrant surgical repair between August 2012 and September 2013. Retrospective medical record review to identify equid patients meeting inclusion criteria of (i) diagnosis with keratomalacia severe enough to warrant surgical repair and (ii) surgical repair with an extracellular matrix graft. Eleven geldings, four mares, and two colts met inclusion criteria. Patients averaged 9years of age. Twelve of 17 eyes (71%) were considered infected based on either corneal cytology (10/17, or 59%) or corneal culture (12/17, or 71%) positive for bacteria (8/17, or 47%) or fungi (9/17, or 53%). At the time topical medications were discontinued, 16 eyes (94%) were visual. One operated eye ruptured 5days postoperatively and was enucleated. Keratouveitis developed in 14/14 eyes that underwent regular examinations approximately 2weeks postoperatively which responded to systemic nonsteroidal anti-inflammatory drug therapy. Extracellular matrix grafts may be a viable alternative to other biomaterials for corneal grafting in equids. Advantages include commercial availability and shelf storage.