Results of grid keratotomy, superficial keratectomy and debridement for the management of persistent corneal erosions in 92 dogs

Abstract

Ninety-two cases of persistent corneal erosions in dogs were analyzed for breed, gender, age and which eye was affected. The results of the treatment of 92 persistent corneal erosions in dogs by superficial keratectomy (SK), grid keratotomy (GK), or debridement with a sterile dry cotton swab are presented. These techniques gave better rates of healing than have been previously reported. All cases of persistent corneal erosions healed in this study. However, it must be noted that three cases treated with debridement only failed to heal after several treatments and were eventually treated with SK. After one procedure 80 out of 92 (87%) had healed. After one procedure, 63% of cases treated with debridement healed, 100% of cases treated with SK healed, and 85% of cases treated with GK healed. At the first postoperative visit, 88% (21/24 cases) of ulcers treated by SK had healed, and 75% (39/52 cases) of ulcers treated by GK had healed. Only 25% of the persistent corneal erosions had healed at the first visit after debridement. All 24 cases of persistent corneal erosions treated with SK healed after one treatment in a mean +/- SD of 9.3 +/- 3.9 days (median of 7 days). Fifty-two cases were managed with GK; 44 (83%) of these healed with one procedure and eight cases required a second GK procedure to resolve. A mean +/- SD of 13.4 +/- 5.1 days (median of 11.5 days) following GK was required for the persistent corneal erosions to heal. Nineteen cases were initially managed by debridement with a dry cotton swab under local anesthesia. Sixteen out of these 19 debridement cases healed (giving an overall healing rate of 84%) in a mean +/- SD time of 23.4 +/- 11.1 days (median 21.5). There were three cases that did not heal with debridement. These cases were debrided at 10-20 day intervals for 30-60 days, and were then treated with SK. Two of these cases healed within 7 days, the other case required 18 days to heal. Sixty-three per cent of persistent corneal erosions treated with debridement healed after one procedure; however, only four out of 19 cases (21%) were healed at the first revisit. Complications were rare: corneal edema occurred in two cases following multiple GK, and excessive granulation tissue in one case was managed with a SK. There was the occurrence of an ulcer adjacent to the surgery site in four cases, two cases following GK and two cases following SK.

Retrospective study on clinical management of indolent ulcers in Boxer dogs

“…Indolent ulcers were often observed in middle-aged Boxer dogs at the Ophthalmology Service practice of the HOVET-FMVZ-USP, what was also frequently observed by many authors in several previous studies (Gelatt & Samuelson 1982, Kirschner et al 1989, Morgan & Abrams 1994, Stanley et al 1998, Gelatt 2003, Ledbetter et al 2003b, Bentley 2005, Slatter 2005. Most studied dogs presented the ocular alteration for some time before ϐirst consultation (Gelatt & Samuelson 1982, Kirschner et al 1989, Stanley et al 1998, Ledbetter et al 2003b, Bentley 2005) and had tried different treatments unsuccessfully.…”

“…Indolent ulcers are spontaneous superϐicial corneal ulcers, commonly observed in middle-aged Boxer dogs that cau-ses pain of acute onset, presents prolonged course and a tendency to relapse (Gelatt & Samuelson 1982, Kirschner 1990, Morgan & Abrams 1994, Stanley et al 1998, Campbell & Murphy 1999, Gelatt 2003, Ledbetter et al 2003b, Bentley 2005, Slatter 2005). The pathogenesis of the condition includes several changes on the ocular surface, which induce its appearance and prolongs the healing period (Gelatt & Samuelson 1982, Kirschner et al 1989, Kirschner 1990, Slatter 2005.…”

“…Despite of its excellent results, those procedures are invasive and may require general anesthesia. Clinical management of the indolent ulcer, including epithelial debridement/cauterization and the administration of topic and/or systemic drugs, may also be capable to treat the cornea (Stanley et al 1998, Ledbetter et al 2003a, Ledbetter et al 2003b, Bentley, 2005.…”

“…The removal of the non adherent corneal epithelium is known as debridement/cauterization (Stanley et al 1998, Ledbetter et al 2003a, Slatter 2005. It can be performed with sterile dry swabs (debridment) (Stanley et al 1998), or utilizing swabs impregnated with different chemical agents (debridement/cauterization), such as trichloroacetic acid, phenol liquid, tincture of iodine or diluted povidone iodine (Gelatt 2003, Slatter 2005.…”

“…It can be performed with sterile dry swabs (debridment) (Stanley et al 1998), or utilizing swabs impregnated with different chemical agents (debridement/cauterization), such as trichloroacetic acid, phenol liquid, tincture of iodine or diluted povidone iodine (Gelatt 2003, Slatter 2005.…”