Use of a nictitating membrane flap for treatment of feline acute corneal hydrops—21 eyes

Abstract

A nictitating membrane flap successfully treated 90.5% of FACH eyes (89.5% of patients).

An unusual case of feline acute corneal hydrops: atypical disease presentation and possible in vivo detection of Descemet's membrane detachment in the cat's unaffected eye

“…A bridge graft was elected over a pedicle graft to theoretically aid in the desired effect of corneal tamponade through anticipated conjunctival contracture as the graft healed. Additional corneal tamponade was achieved through the placement a nictitating membrane flap, which has recently been reported as an effective treatment option for FACH . Although follow‐up in this case was limited, the combined surgical approach in this case appeared to have prevented further complication from FACH (such as corneal perforation), restored comfort, and preserved vision.…”

“…Surgical repair was elected and consisted of a conjunctival bridge graft (Fig. a), nictitating membrane flap, and temporary tarsorrhaphy, performed under general anesthesia. The patient was discharged and prescribed ofloxacin 0.3% (1 drop q 4 h), amoxicillin trihydrate/clavulanate potassium 62.5 mg/ml powder for suspension (Clavamox Drops; Zoetis, Kalamazoo, MI, USA) (13.75 mg/kg q 12 h), atropine sulfate 1% (1 drop q 24 h), and buprenorphine hydrochloride 0.3 mg/ml solution (Buprenex; Reckitt Benckiser Pharmaceuticals Inc., Richmond, USA) (0.01 mg/kg q 8‐12 h PRN for pain).…”

“…In cats, an association between DM rupture and FACH has been long suspected but has been only recently verified histologically in several enucleated eyes . The SD‐OCT findings in the patient's left eye (Fig.…”

“…The cat in this report was of a similar age to that of other FACH‐affected cats in two larger case series but did not demonstrate previously proposed risk factors for FACH including uveitis, reported trauma, evidence of an infectious disease process, evidence of an inherited corneal stromal dystrophy, or a history of receiving cyclosporine or other immunomodulatory therapies…”

“…In humans with ectatic corneal syndromes such as keratoconus, acute corneal hydrops (ACH) can develop secondary to Descemet's membrane (DM) rupture, which can be clearly identified using AS‐OCT . Descemet's membrane rupture has been long suspected to play a role in FACH but only recently reported histologically in enucleated globes of several cats . Contrary to human ACH, in vivo DM detachment has not been documented in any cases of FACH.…”