Targeted lamellar keratoplasty in the horse: a paradigm shift in equine corneal transplantation.

This research proposes a shift in how equine keratopathies (corneal diseases in horses) are treated, suggesting targeted lamellar keratoplasty (removing and replacing specific diseased layers of the cornea) as a more appropriate method than the widely-used full thickness penetrating keratoplasty (PK).

Overview of the Research

The article discusses a new perspective in the treatment of equine corneal diseases. Traditionally, full thickness penetrating keratoplasty (PK) – a process where the entire diseased cornea is replaced – has been used. However, in this research, the author suggests that this approach should be used sparingly and proposes a more targeted approach, called lamellar keratoplasty.

• The focus of this targeted approach is only on the diseased layers of the cornea. Only these affected layers would be replaced, leaving the healthy layers intact. This contrasts from full-thickness PK where the entire cornea, both diseased and healthy layers, is replaced.
• This new technique is presented as a shift in paradigm in the field of equine corneal transplantation.

Lamellar keratoplasty vs. Penetrating keratoplasty (PK)

One of the main points detailed in the research is the comparison between the traditional method (full thickness PK) and the proposed technique (lamellar keratoplasty).

• PK involves a full replacement of the cornea, irrespective of whether some layers are healthy or not. Despite having had positive results in treating equine keratitis (corneal inflammation), the author suggests that this approach should be used with much less frequency.
• On the other hand, the lamellar keratoplasty focuses specifically on the diseased layers of the cornea. This means that the healthy layers are retained, and only the affected ones are surgically replaced. This offers a more targeted approach towards treating equine keratopathies.

Implications of the Research

The suggested shift in paradigm towards targeted corneal transplantation has several potential implications:

• If effectively executed, it could lead to improved treatment outcomes by retaining the healthy parts of the cornea and specifically replacing only the diseased layers.
• It could also potentially reduce chances for complications arising from total corneal replacement, such as graft rejection.
• The new approach could also set a precedent for treating similar corneal diseases in other species, bringing a broader impact in the field of corneal transplantation across both veterinary and human medicine.