Evaluation of accelerated corneal collagen cross‐linking for the treatment of bullous keratopathy in eight dogs (10 eyes)

Abstract

CXL is a useful treatment option for BK in dogs, despite the short-lasting effects on corneal thickness. Patient comfort improved rapidly after a single procedure, although CXL did not achieve resolution of corneal edema. Treatment protocols may be refined to produce more durable effects on corneal edema.

Corneal collagen cross‐linking following superficial keratectomy as treatment for corneal endothelial cell dystrophy in dogs: Preliminary clinical study

“…Our results demonstrated that CXL combined with SK reduced corneal thickness but caused only a transient effect on corneal clarity. CT was significantly reduced immediately after the treatment, but progressively increased during the follow‐up period as observed in previous studies evaluating the effect of CXL on bullous keratopathy in human and veterinary patients …”

“…Patients were comfortable after the treatment but the initially decreased corneal thickness gradually increased to preoperative values during the first 4 months after CXL . More recently, Famose observed a long‐lasting decrease in corneal thickness but also reported a return to preoperative values 6 months after accelerated CXL in ten eyes of ten dogs …”

“…Slit lamp biomicroscopy and OCT were used to examine the cornea during the follow‐up period, every week for at least 3 weeks (from 3 weeks to 6 months). Corneal clarity scores were defined as follows: 0 = no edema, clear cornea, totally transparent; 1 = slight corneal edema, slight loss of transparency with loss of posterior corneal detail; 2 = moderate edema, loss of transparency but iris details visible; 3 = intense edema, loss of transparency, iris visible but with loss of visibility of surface details; and 4 = very opaque cornea, iris not visible . In addition, clinical signs representing patient discomfort including blepharospasm, frequent blinking, and epiphora were registered when observed.…”

“…reported that CXL decreases corneal edema and increases visual acuity in humans with bullous keratopathy . Two studies describing the use of CXL to treat bullous keratopathy in dogs have been published in which an initial decrease in corneal thickness with a return to the pretreatment thickness after 4‐6 months was reported . Therefore, removal of the thick edematous cornea via superficial keratectomy was combined with CXL in this study (Figure ) to determine the effects on corneal thickness, transparency, and patient comfort.…”

Superficial keratectomy as a treatment for non‐healing corneal ulceration associated with primary corneal endothelial degeneration

“…Bullous keratopathy and associated corneal ulceration can occur in advanced stages of PCED if the edema coalesces into sub‐epithelial bullae that then rupture. This superficial corneal ulceration can cause marked pain that can be protracted because the ulcers are often non‐healing or take extended periods of time to heal . Several different surgical techniques to treat PCED‐associated corneal ulceration, with their relative advantages and disadvantages, have been described in the veterinary literature .…”