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

Abstract

Objective To analyze a study population of dogs with primary corneal endothelial degeneration (PCED) for information on the patterns of disease and to report the efficacy of superficial keratectomy (SK) for resolution of non‐healing corneal ulcers associated with PCED. Animals studied Primary corneal endothelial degeneration was diagnosed in 238 dogs between 1998 and 2017. Corneal ulceration associated with PCED was present in 89 dogs (109 eyes), of which 47 eyes were treated with SK. Procedures A retrospective assessment of medical records was performed to determine the signalment patterns of PCED, and the success rate of the SK procedure for resolving PCED‐associated corneal ulceration. Descriptive statistics were reported on the signalment of PCED cases, with odd ratios and confidence intervals calculated to detect breed predispositions. Results Primary corneal endothelial degeneration was diagnosed in 238 dogs, 40.8% were female and 59.2% were male, with a mean age at diagnosis of 11.4 years. Dachshunds, Dalmatians, English Springer Spaniels, Welsh Springer Spaniels, Chihuahuas, Cocker Spaniels, and Golden Retrievers were significantly over‐represented. All PCED‐affected Dalmatians developed associated corneal ulceration. Follow‐up information was available for 41/47 eyes treated with SK. At the first reassessment, 87.8% were healed which increased to 97.6% with subsequent monitoring. Four eyes (9.8%) had late corneal ulcer occurrence following SK, at a median time following SK of 182 weeks post‐surgery. Conclusions Superficial keratectomy was an effective option for resolving painful non‐healing corneal ulcers associated with PCED. Dalmatians may be at increased risk of developing PCED‐associated corneal ulceration.

Treatment outcome of spontaneous chronic corneal epithelial defects in brachycephalic dogs comparing Boxers and non‐Boxers: A retrospective multicenter study of 420 dogs

“…However, this is expected as DBD was the most frequent mechanical treatment elected (264/464). Interestingly, one case did not heal following an SK, however, this is still similar to previous studies where SK was reported to have a near 100% success rate 9,27 . In the Boxer group, 19 SCCEDs required a second procedure and in the non‐Boxer group 32 cases received a second procedure with one requiring a third procedure.…”

Treatment outcome of spontaneous chronic corneal epithelial defects in brachycephalic dogs comparing Boxers and non‐Boxers: A retrospective multicenter study of 420 dogs

“…However, this is expected as DBD was the most frequent mechanical treatment elected (264/464). Interestingly, one case did not heal following an SK, however, this is still similar to previous studies where SK was reported to have a near 100% success rate 9,27 . In the Boxer group, 19 SCCEDs required a second procedure and in the non‐Boxer group 32 cases received a second procedure with one requiring a third procedure.…”

A multicenter retrospective evaluation of the prevalence of known and presumed hereditary eye diseases in Lagotto Romagnolo dog breed within a referral population in Italy (2012–2020)

“…The late‐onset might be a correlation between natural aging of the endothelium, the resulting cell loss and predisposition by the hereditary disease. Furthermore, as in other breeds, no gender predisposition was associated with corneal endothelial dystrophy in Lagotto Romagnolo 38,41,43,45 …”

“…Furthermore, as in other breeds, no gender predisposition was associated with corneal endothelial dystrophy in Lagotto Romagnolo. 38,41,43,45 Based on our results, retinal dysplasia, lens instability, progressive retinal atrophy, and keratoconjunctivitis sicca have been shown to have a prevalence above 5% in the Lagotto Romagnolo dog breed in Italy. These ocular diseases are potential causes of blindness in dogs; specifically, eight Lagotto Romagnolo dogs already presented with visual deficits at the first examination.…”

Partial incision blunt scissors lamellar keratectomy under topical anesthesia for the treatment of presumed calcific corneal degeneration in dogs

“…In contrast, superficial keratectomy performed in 47 eyes under general anesthesia for non‐healing ulcers associated with canine corneal endothelial degeneration resulted in zero cases of reported perforation 22 . Ulcer depth was not specified, but there was no mention of deep stromal ulceration or descemetocele in this report and thus a direct comparison may be inappropriate.…”

Treatment outcome of spontaneous chronic corneal epithelial defects in brachycephalic dogs comparing Boxers and non‐Boxers: A retrospective multicenter study of 420 dogs

“…However, this is expected as DBD was the most frequent mechanical treatment elected (264/464). Interestingly, one case did not heal following an SK, however, this is still similar to previous studies where SK was reported to have a near 100% success rate 9,27 . In the Boxer group, 19 SCCEDs required a second procedure and in the non‐Boxer group 32 cases received a second procedure with one requiring a third procedure.…”

A multicenter retrospective evaluation of the prevalence of known and presumed hereditary eye diseases in Lagotto Romagnolo dog breed within a referral population in Italy (2012–2020)

“…The late‐onset might be a correlation between natural aging of the endothelium, the resulting cell loss and predisposition by the hereditary disease. Furthermore, as in other breeds, no gender predisposition was associated with corneal endothelial dystrophy in Lagotto Romagnolo 38,41,43,45 …”

“…Furthermore, as in other breeds, no gender predisposition was associated with corneal endothelial dystrophy in Lagotto Romagnolo. 38,41,43,45 Based on our results, retinal dysplasia, lens instability, progressive retinal atrophy, and keratoconjunctivitis sicca have been shown to have a prevalence above 5% in the Lagotto Romagnolo dog breed in Italy. These ocular diseases are potential causes of blindness in dogs; specifically, eight Lagotto Romagnolo dogs already presented with visual deficits at the first examination.…”

Partial incision blunt scissors lamellar keratectomy under topical anesthesia for the treatment of presumed calcific corneal degeneration in dogs

“…In contrast, superficial keratectomy performed in 47 eyes under general anesthesia for non‐healing ulcers associated with canine corneal endothelial degeneration resulted in zero cases of reported perforation 22 . Ulcer depth was not specified, but there was no mention of deep stromal ulceration or descemetocele in this report and thus a direct comparison may be inappropriate.…”

Treatment outcome of spontaneous chronic corneal epithelial defects in brachycephalic dogs comparing Boxers and non‐Boxers: A retrospective multicenter study of 420 dogs

“…However, this is expected as DBD was the most frequent mechanical treatment elected (264/464). Interestingly, one case did not heal following an SK, however, this is still similar to previous studies where SK was reported to have a near 100% success rate 9,27 . In the Boxer group, 19 SCCEDs required a second procedure and in the non‐Boxer group 32 cases received a second procedure with one requiring a third procedure.…”

A multicenter retrospective evaluation of the prevalence of known and presumed hereditary eye diseases in Lagotto Romagnolo dog breed within a referral population in Italy (2012–2020)

“…The late‐onset might be a correlation between natural aging of the endothelium, the resulting cell loss and predisposition by the hereditary disease. Furthermore, as in other breeds, no gender predisposition was associated with corneal endothelial dystrophy in Lagotto Romagnolo 38,41,43,45 …”

“…Furthermore, as in other breeds, no gender predisposition was associated with corneal endothelial dystrophy in Lagotto Romagnolo. 38,41,43,45 Based on our results, retinal dysplasia, lens instability, progressive retinal atrophy, and keratoconjunctivitis sicca have been shown to have a prevalence above 5% in the Lagotto Romagnolo dog breed in Italy. These ocular diseases are potential causes of blindness in dogs; specifically, eight Lagotto Romagnolo dogs already presented with visual deficits at the first examination.…”

Partial incision blunt scissors lamellar keratectomy under topical anesthesia for the treatment of presumed calcific corneal degeneration in dogs

“…In contrast, superficial keratectomy performed in 47 eyes under general anesthesia for non‐healing ulcers associated with canine corneal endothelial degeneration resulted in zero cases of reported perforation 22 . Ulcer depth was not specified, but there was no mention of deep stromal ulceration or descemetocele in this report and thus a direct comparison may be inappropriate.…”