Corneoconjunctival transposition with and without ACell^®for deep corneal ulcer repair in 18 dogs

Abstract

Objective To document a case series using corneoconjunctival transposition (CCT) surgery with and without bioscaffolding matrix (ACell®) to repair deep corneal ulcers and perforations in dogs. Animals studied Eighteen dogs of various breeds that presented with deep or perforating corneal ulcers. Procedures Corneoconjunctival transposition grafts with or without ACell® were sutured using a simple interrupted 8‐0 or 9‐0 polyglactin 910 pattern. Results A total of eighteen dogs (19 eyes) were diagnosed with deep corneal ulcers (n = 7) and perforating corneal ulcers (n = 12). A CCT was performed in all eyes, with ten of them additionally receiving an ACell® graft. The majority of lesions were located axially in 14/19 (81%) eyes. Grafts were harvested from dorsal (n = 8), temporal (n = 5), ventral (n = 4), or nasal (n = 2) quadrants. Brachycephalic breeds (13/18) were over‐represented. Keratoconjunctivitis sicca was present in 10/19 eyes (52.6%). Bacterial isolates were cultured from 8/19 eyes. Post‐operative therapy included topical antibiotics, plasma, cycloplegics, oral antibiotics, and oral nonsteroidal anti‐inflammatory drugs. CCT integration with and without ACell® occurred at a median of 20 days (range 7‐38 days) post‐operatively with no significant difference between groups. Median follow‐up time was 188 days. Short‐term post‐operative complications included granulation tissue formation (19/19), corneal edema (4/19), graft retraction (4/19), and anterior synechia (1/19). Long‐term complications in 14 eyes with follow‐up >30 days included superficial corneal pigmentation (6/14) and epithelial inclusion cysts (5/14). Two eyes were nonvisual at last follow‐up due to cataract formation. Conclusions Corneoconjunctival transposition with ACell® can be utilized for corneal ulcer repair in dogs.

Surgical treatment of canine and feline descemetoceles, deep and perforated corneal ulcers with autologous buccal mucous membrane grafts

“…In addition, their acellularity is associated with a lower immune response and therefore limited graft rejection, 22,30 and there is a good final transparency of the cornea. 29,30 However, their use alone is not recommended in the case of a perforation or very deep ulceration, 36 and some authors suggest that their collagenous nature could be potentially used as a substrate for the action of collagenases. 22 In our study, most cases presented severe lesions such as descemetoceles or corneal perforation with or without iris prolapse (25/27 eyes), and concomitant corneal melting was present in 13/27 eyes.…”

“…In addition, their acellularity is associated with a lower immune response and therefore limited graft rejection, 22 , 30 and there is a good final transparency of the cornea. 29 , 30 However, their use alone is not recommended in the case of a perforation or very deep ulceration, 36 and some authors suggest that their collagenous nature could be potentially used as a substrate for the action of collagenases. 22 …”

“…Severe ulcerative corneal lesions can be surgically treated using several materials which can be divided in four groups: homologous tissue, 11–18 heterologous tissue, 17,19–24 acellular biomaterial, 22,25–30 and synthetic material 31–33 . A combination of different techniques has also been described 34–36 …”

“…[31][32][33] A combination of different techniques has also been described. [34][35][36] Some of these materials require specialized instrumentation, are expensive, and are difficult to obtain or store. Moreover, some can only be used for small, superficial corneal defects and others prevent corneal evaluation during the follow-up period.…”

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 .…”