Modified penetrating keratoplasty with Acell® bioscaffold implant in seven horses with deep full-thickness corneal stromal abscess.
Abstract: To describe and evaluate a modified penetrating keratoplasty technique utilizing ACell® for management of equine deep stromal or full-thickness corneal stromal abscesses (SA). Methods: Cases presenting to the University of Georgia Ophthalmology service for surgical management of SA necessitating penetrating keratoplasty (PK) were included in the study population. Surgery entailed the use of an ACell® disk sutured within the deep level of a stepped full-thickness corneal incision with an overlying conjunctival pedicle flap placed in the superficial step incision. Patients were evaluated for success as defined by a comfortable, visual outcome. Results: Surgery was performed in seven horses. Conjunctival flap incorporation and globe retention occurred in all patients. Functional vision was maintained in six of seven eyes (85.7%) at last follow-up examination (mean of 87.6 days [range 41-251 days]). Mean size of ACell® implant was six millimeters (range 4-8 mm). Postoperative complications included moderate to severe anterior uveitis (n = 2), diffuse keratitis (n = 1), incipient cataract formation (n = 3), and anterior and posterior synechiae (n = 1). Conclusions: This technique is a viable option for treatment of equine SA requiring PK. The use of bioscaffold implant is an alternative to frozen and fresh donor cornea transplantation.
© 2016 American College of Veterinary Ophthalmologists.
Publication Date: 2016-02-03 PubMed ID: 26840652DOI: 10.1111/vop.12349Google Scholar: Lookup
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Summary
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This research paper discusses a new technique to manage corneal abscess in horses using ACell bioscaffolding in a modified penetrating keratoplasty. The study found this approach to be a favorable alternative to traditional donor cornea transplantation.
Study Objective and Methods
- The goal of the study was to assess and describe a modified penetrating keratoplasty (PK), a type of surgery to replace the cornea, utilizing ACell. This is a bioscaffold material used in regenerative medicine, aimed at managing deep stromal or full-thickness corneal stromal abscesses (SA), a type of eye infection, in horses.
- The cases selected for this research were those presented to the University of Georgia Ophthalmology service needing surgical management of SA via PK.
- The surgical procedure involved the implantation of a disc of ACell within the deep level of a layered full-thickness corneal incision. A conjunctival pedicle flap, a graft of the conjunctiva, was positioned in the superficial step incision.
- Success was evaluated based on the retention of comfortable and functional vision after the surgery.
Results of the Study
- The modified PK was carried out on seven horses and in every case the conjunctival flap was successfully incorporated and the globe of the eye was retained.
- Functional vision was maintained in six out of the seven operated eyes (85.7%) during the last follow-up examination which was conducted on average 87.6 days after the operation (range 41-251 days).
- The average size of the ACell implant was six millimeters (range 4-8 mm).
- Postoperative complications were noted in some cases, including moderate to severe anterior uveitis (inflammation of the uvea) in two cases, diffuse keratitis (inflammation of the cornea) in one case, the formation of an incipient cataract in three cases, and anterior and posterior synechiae (adhesions between the iris and other parts of the eye) in one case.
Conclusion of the Research
- According to the findings, the technique of using an ACell bioscaffold implant in a modified PK is a viable option for treating equine SA.
- The use of a bioscaffold implant offers an alternative to the traditional method of corneal transplantation using fresh or frozen donor corneas.
Cite This Article
APA
Cichocki BM, Myrna KE, Moore PA.
(2016).
Modified penetrating keratoplasty with Acell® bioscaffold implant in seven horses with deep full-thickness corneal stromal abscess.
Vet Ophthalmol, 20(1), 46-52.
https://doi.org/10.1111/vop.12349 Publication
Researcher Affiliations
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
MeSH Terms
- Abscess / surgery
- Abscess / veterinary
- Animals
- Corneal Diseases / surgery
- Corneal Stroma / surgery
- Female
- Horse Diseases / surgery
- Horses
- Keratoplasty, Penetrating / instrumentation
- Keratoplasty, Penetrating / methods
- Keratoplasty, Penetrating / veterinary
- Male
- Tissue Scaffolds / veterinary
Citations
This article has been cited 1 times.- Steinmetz A, Bernhard A, Minkwitz C, Böttcher D. [Surgical treatment of a perforated cornea in a zebra]. Ophthalmologe 2019 Oct;116(10):967-969.
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