Surgical Repair of Deep Corneal Ulcer, Descemetocele, and Perforation by Conjunctival Flap in Dogs and Cats

Abstract

Deep corneal ulcers, descemetoceles, and corneal perforation are common disorders seen in companion animals. Here I describe the outcomes and complications of surgical repair of deep or perforating corneal ulcers using bulbar conjunctival flap in 62 eyes from 55 patients (42 dogs and 13 cats). Two surgical techniques of conjunctivai flaps were performed, including rotational pedicle flap and circumferential 360° conjunctival flap. All corneal lesions were debrided by keratectomy and then treated by punctate keratotomy prior to flap placement. The flaps were harvested and sutured onto the cornea and left on sites until they were removed following 3-8 weeks post-operatively. Rotational pedicle conjunctival flap was performed in 57 eyes and 360° circumferential conjunctival flap for 5 eyes. Corneal lesions were recovered in 53 eyes (85.5%) with restored corneal integrity and thickness following removal of the flaps. There was no difference in recovery rate between two techniques used and animal species. Lack of flap viability and poor blood supply postoperatively was observed in 3 eyes. Early flap failure of loose or detached flap from corneal lesions was seen in 6 eyes exclusively in brachycephalic dog breeds with prominent globes. The major complications of conjunctival flap surgery were localized corneal opacity and granulation tissue formation in previously affected regions that may impair vision. More than 85% of the affected eyes showed comfortable following flap removal. The overall outcomes of the surgeries in this study revealed that the techniques of conjunctival flaps were effective to restore and strengthen the weakened corneal structure and relieve ocular discomfort in severely affected corneas.