Melting Keratitis in Dogs and Cats

An Assay System to Evaluate Riboflavin/UV-A Corneal Phototherapy Efficacy in a Porcine Corneal Organ Culture Model

“…Although melting ulcers may respond to medical management, a progression of stromal dissolution and corneal edema is frequent, serious, and rapidly progressive, and surgical treatment is necessary to avoid corneal perforation [ 3 , 5 , 6 , 7 ]. In recent years, research efforts, both in human and veterinary medicine, have been directed in the search for alternative or complementary methods that could support the healing processes of corneal ulcerative diseases [ 3 , 7 , 8 ].…”

“…UV-A/riboflavin corneal cross-linking (CXL) was introduced as a treatment for humans in 1999 and is currently used to treat primary corneal ectasia, such as progressive keratoconus, and iatrogenic corneal ectatic disorders [ 4 , 6 , 7 , 9 , 10 , 11 , 12 ]. The technique works through the application of riboflavin (vitamin B2) as a photosensitizer and UV-A irradiation of the cornea with the aim of strengthening the corneal biomechanics due to the increased formation of covalent bonds between the stromal proteins by photopolymerization and photooxidation processes [ 8 ].…”

Surgical management of infectious and noninfectious melting corneal ulcers in cats

“…They spread rapidly to the remaining surface and layers of the cornea. They are characterized by a gray, soft, mucoid, gelatinous appearance of the cornea [15,16]. Due to this appearance, these lesions recalled melting ulcer or keratomalacia [5,11,12].…”

“…The aim of operative treatment is to remove the dead tissues and debris, accelerate healing, protect the cornea from external adverse effects, and fill the defect area with conjunctival or corneal tissue [19]. Many surgical techniques are used for this purpose, including keratectomy combined with the third eyelid flap technique [15], corneo-conjunctival transposition [12], amniotic membrane transplantation, biomaterial grafts, conjunctival grafting, perforating keratoplasty, and collagen cross-linking [2,21,22]. The use of conjunctival pedicle flaps has been recommended by most surgeons in the treatment of melting ulcer in animals [8].…”

“…However, the use of this technique has been reported to be contraindicated in the treatment of progressive dissolution ulcers because of the inability to rapidly supply blood or fibrovascular tissue to the ulcers [14]. This method was applied by Ion et al [15] in melting ulcers in cats and dogs, and contrary to the literature, they obtained positive results. In the current study, we applied this method after lamellar keratectomy regardless of the depth and width of the corneal lesions in 20 cat cases and we achieved excellent results in all cases.…”