Comparative evaluation of decellularized bovine omentum alone and in combination with mitomycin-C in the management of corneal injuries in dogs

Abstract

Background and Aim: Ulcerative corneal lesions are common ocular affections encountered in veterinary ophthalmology, having a higher incidence in dogs with brachycephalic conformation. Prompt and effective diagnosis and repair are necessary to avoid corneal perforation and restore vision. Corneal wound healing is a complex phenomenon often resulting in vision impairment as a consequence of corneal fibrosis and pigmentation. The present study investigated the efficacy of decellularized and gamma-irradiated bovine omentum as an extracellular matrix scaffold in the reconstruction of extensive and full-thickness corneal defects, and the cytotoxic effects of mitomycin-C (MMC) to prevent corneal fibrosis and pigmentation. Materials and Methods: Twelve injured corneas of eleven dogs irrespective of breed, age, and sex were randomly divided into Groups I and II, consisting of six corneas each. Under general anesthesia, corneal grafting with decellularized and gamma-irradiated bovine omentum was carried out in Group I, whereas Group II corneas underwent single time intra-operative application of topical MMC for 2 min before corneal grafting with the same material. Epithelialization of cornea and observations including corneal edema, neovascularization, the extent of pigmentation, corneal clarity, and scarring was recorded on days 7, 14, 21, and 60 postoperatively. Results: All corneas in Group I showed early epithelialization by day 7 compared to Group II where the MMC delayed epithelialization in 50% of the corneas. Visual function scores improved greatly from 0.17±0.17 in Group II on the day of presentation to 1.0±00 by the end of the observation period compared to Group I (from 0.33±0.15 to 0.88±0.11). Although epithelialization and corneal healing were delayed, 50% of the corneas recovered with undetectable corneal scar and melanosis at the end of the observation period in Group II due to the anti-fibrotic effect of MMC. Conclusion: From the present study, it was concluded that re-epithelialization of the cornea was enhanced by corneal grafting with decellularized bovine omentum, and application of MMC was effective in delaying corneal fibrosis and pigmentation.

New Devitalized Freeze-Dried Human Umbilical Cord Amniotic Membrane as an Innovative Treatment of Ocular Surface Defects: Preclinical Results

“…Firstly, the lhUC-AM product has not been compared to a standard surgery. So, we cannot assure the superiority of this product over the other treatments presented in the introduction of this article [1,[6][7][8][9][10][11][12][13][14][15][16][17][18][19].…”

“…However, the corneal structure is partially restored and the transparency of the cornea is delayed for months or is impaired due to scarring. Trials with xenografts biomaterials were also realized with equine or bovine pericardium [12,13], porcine small intestinal submucosa [14][15][16], porcine urinary bladder [17,18] and bovine omentum [19] with promising results in animals. However, to the best of our knowledge, these biomaterials have never been widely distributed or commercialized for cornea repair, especially in humans.…”

The use of acellular porcine corneal stroma xenograft (BioCorneaVet™) for the treatment of deep stromal and full thickness corneal defects: A retrospective study of 40 cases (2019–2021)

“…BOS is characterized by exophthalmos, macroblepharon, lagophthalmos, reduced corneal sensitivity, entropion, and trichiasis at the medial canthus and qualitative/quantitative tear film abnormalities 5,27,28 1,12 and penetrating keratoplasty with fresh or frozen material, 1 tissue adhesives, 29 conjunctival pedicle graft (CPG), 30 corneoconjunctival transposition (CCT), 2,31 biomaterials such as amniotic membrane, 32,33 pericardium, 34 peritoneum, 35 renal capsule, 36 urinary bladder, 37,38 omentum, 39 and porcine small intestinal submucosa (SIS) 6,40,41 . Surgical technique selection is generally guided by location and depth of the corneal defect, concurrent diseases, biomaterials availability, and surgeon experience and preferences 9 .…”

Novel Treatment of Chronic Superficial Keratitis in Dog – Case Report

“…(Song et al 2007). MMC has been used intra-operatively after surface ablation to prevent corneal haze formation (Hu et al 2009) and to restore clarity after surgical management of corneal injuries (Thajunnisa et al 2020).…”