Conjunctival Pedicle Graft in Dogs and Cats: A Retrospective Study of 88 Cases

Abstract

Seventy-eight dogs and ten cats with corneal lesions, including deep corneal stromal ulcers (n = 32), keratomalacia and recurrent erosions (n = 25), descemetocoeles (n = 18), staphylomas and perforating corneal defects (n = 5) and feline corneal sequestrations (n = 8) were treated with 3 types of conjunctival pedicle grafts. Breed, age, sex of the patients, size and depth of corneal lesions, suture material used, surgical technique and postoperative application of antibiotics were evaluated to determine their influence on the success rate of conjunctival pedicle graft. The success rate of the therapy was high (93.18%) and depended chiefly on the surgical technique employed.

Retrospective evaluation of corneal reconstruction usingACell Vet™alone in dogs and cats: 82 cases

“…Corneal reconstruction using ACell Vet ™ alone resulted in a comfortable globe in 93% of cases, with 87% of those cases retaining vision (81% overall). These outcomes are similar to those previously reported for an acellular submucosa (Acell™ or BioSISt™) graft covered by a conjunctival graft and for conjunctival pedicle grafts and corneoscleral transposition grafts but lower than for an SIS graft alone . Although there is no objective way to compare the severity of the presenting lesions between the present study and the series using SIS for corneal reconstruction, it is the authors' impression that the higher number of cases seen in the current study with severe complications (resulting in glaucoma, phthisis, or enucleation) can be attributed to the severity of the lesions at presentation.…”

“…A conjunctival pedicle graft is a versatile surgical technique that can be utilized in many different situations and as such is likely the most commonly used method to repair deep corneal defects in veterinary medicine. Conjunctival pedicle grafts provide an immediate source of fibroblasts, blood vessels, epithelial cells, and antimicrobial and antiproteolytic elements to the grafted site . However, conjunctival grafts provide minimal tectonic support and as conjunctiva is inherently opaque, they impair vision.…”

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

“…Conjunctival pedicles remain an effective biomaterial for surgical repair of the cornea in veterinary species, achieving both functional and anatomical success. [19][20][21] Conjunctiva lends excellent structural integrity to a compromised cornea and provides blood vessels to an otherwise avascular region, delivering nutrients for epithelial proliferation, protective leukocytes, antibodies, anticollagenase compounds, and systemic antimicrobials. 1,21 However, conjunctival flaps are opaque, produce unpredictable and potentially extensive corneal fibrosis, and may severely impair optical clarity when lesions are large or graft resection impractical.…”

“…Conjunctival pedicles remain an effective biomaterial for surgical repair of the cornea in veterinary species, achieving both functional and anatomical success . Conjunctiva lends excellent structural integrity to a compromised cornea and provides blood vessels to an otherwise avascular region, delivering nutrients for epithelial proliferation, protective leukocytes, antibodies, anticollagenase compounds, and systemic antimicrobials .…”

Deep anterior lamellar keratoplasty of dog eyes using the big-bubble technique

“…Corneal ulceration is a common and clinically important ocular disease in dogs. In the case of large and deep corneal defects, various surgical managements have been attempted to promptly and effectively repair the cornea, including conjunctival pedicle graft [ 25 ], corneal-scleral transposition [ 24 ] and autogenous corneal graft [ 8 ]. In addition, preserved biological membranes including pericardium [ 2 ], intestinal submucosa [ 11 ], amniotic membrane [ 7 ] and renal capsule [ 3 ] are used in medicine and in veterinary general surgery for deep corneal defects and perforations.…”