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Home / Equine Research Bank / Vet Surg / Long-term outcome of autologous fascia lata grafting with co...
Veterinary surgery : VS2023; 52(7); 1032-1040; doi: 10.1111/vsu.13969

Long-term outcome of autologous fascia lata grafting with conjunctival flap overlay in horses with ulcerative keratitis and keratomalacia.

Abstract: To describe the technique, postoperative complications, and outcome after autologous fascia lata grafting with conjunctival flap overlay in horses with ulcerative keratitis and keratomalacia. Methods: Retrospective case series. Methods: Eleven horses with ulcerative keratitis and keratomalacia. Methods: Horses included had undergone fascia lata grafting with conjunctival flap overlay due to impending or recent corneal perforation. Preceding therapy, lesion characteristics, postoperative complications, and short- and long-term outcomes were recorded. Results: Postoperative complications included complete (1/11) or partial (2/11) dehiscence of the conjunctival flap and fascia lata graft, postoperative pneumonia (1/11), intermittent hypercreatinemia (2/11) and mild uveitis after trimming of the conjunctival flap (9/10). The donor sites healed without complications (11/11). A satisfactory short-term outcome (at cessation of medical therapy) was achieved in all horses (11/11). Long-term follow-up (median 29 months, range 7-127 months) was available for 10/11 horses. A comfortable eye with functional vision was achieved in 9/10 horses with long-term follow-up, including 3/4 horses with prior corneal perforation and 1/11 horses in which the fascia lata graft completely dehisced 15 days after surgery. Enucleation was required in a single horse (1/10) after phthisis bulbi developed 7 months postoperatively. Conclusions: Fascia lata grafting with conjunctival flap overlay appears to be a viable solution for globe preservation in horses with ulcerative keratitis and keratomalacia. Long-term ocular comfort with functional visual outcomes can be achieved in most cases with limited concerns for donor site morbidity while bypassing acquisition, storage or lesion-size limitations related to other biomaterials.
© 2023 The Authors. Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.
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Publication Date: 2023-06-13 PubMed ID: 37309748DOI: 10.1111/vsu.13969Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research article investigates the long-term results of a surgical procedure using an autologous fascia lata graft with a conjunctival flap overlay for the treatment of horses with ulcerative keratitis and keratomalacia. The findings suggest that it is an effective solution to preserve the globes of horses with these conditions with limited concerns related to donor site morbidity.

Study Methodology

  • The researchers carried out a retrospective case series, using a total of eleven horses affected by ulcerative keratitis and keratomalacia. These horses had all undergone fascia lata grafting with a conjunctival flap overlay because of corneal perforation or the threat of it.
  • The team recorded various aspects of each case which included the type of treatment received before the study, the characteristics of the lesion, any complications after the operation, and outcomes in both short and long term.

Early Results

  • Following the procedure, some horses experienced full or partial dehiscence of the conjunctival flap and fascia lata graft, pneumonia, fluctuating hypercreatinemia, and mild uveitis after the trimming of the conjunctival flap.
  • Despite these complications, the donor sites healed properly in all the horses, and a satisfactory short-term outcome (noted at the cessation of medical therapy) was achieved for all the horses.

Long-Term Outcomes

  • Long-term follow-up was available for ten out of eleven horses, over durations ranging from 7 to 127 months. Nine out of these ten horses displayed ocular comfort and functional vision, including horses with prior corneal perforation and one whose fascia lata graft fully dehisced 15 days post-surgery.
  • One horse needed to have an eye enucleated after phthisis bulbi developed seven months post-surgery.

Conclusion

  • The study hence concludes that autologous fascia lata grafting with a conjunctival flap overlay is a promising solution for globe preservation in horses affected by ulcerative keratitis and keratomalacia.
  • It offers the possibility of long-term ocular comfort with functional visual outcomes in most cases, while also having limited concerns related to donor site morbidity.
  • The technique also seems to circumvent many of the issues connected to the use of other biomaterials, such as procurement, storage, or size limitations of the lesion.

Cite This Article

APA
Hoerdemann M, Yarbrough T. (2023). Long-term outcome of autologous fascia lata grafting with conjunctival flap overlay in horses with ulcerative keratitis and keratomalacia. Vet Surg, 52(7), 1032-1040. https://doi.org/10.1111/vsu.13969

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English
Volume: 52
Issue: 7
Pages: 1032-1040

Researcher Affiliations

Hoerdemann, Mona
  • Dubai Equine Hospital, Dubai, United Arab Emirates.
Yarbrough, Thomas
  • Dubai Equine Hospital, Dubai, United Arab Emirates.

MeSH Terms

  • Fascia Lata / transplantation
  • Retrospective Studies
  • Vitamin A Deficiency
  • Horse Diseases / surgery
  • Animals
  • Treatment Outcome
  • Corneal Ulcer / surgery
  • Corneal Ulcer / veterinary
  • Corneal Ulcer / complications
  • Corneal Perforation / complications
  • Corneal Perforation / veterinary
  • Postoperative Complications / veterinary
  • Horses

Grant Funding

  • Open access funding provided by the Iowa State University Library.

References

This article includes 21 references
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