Visual outcome evaluation of complicated perforating corneal injuries after surgical repair in 45 cats

Corneal perforations and lacerations are common causes of blindness. These injuries require immediate treatment to preserve the anatomical integrity of the cornea. The purposes of our study were to demonstrate the common complications of traumatic and nontraumatic penetrating corneal injuries in cats and to assess the visual outcome after surgical repair of these cases. The present study included 45 cats with traumatic and nontraumatic perforated cornea. The cats were treated either by suturing of the corneal defect, conjunctival flap, or treating the associated complications. Regarding the surgical outcomes after a successful conjunctival flap, the corneal integrity and transparency of the eye with the potential for vision were restored in 14 cats, corneal vascularization and granulation tissue in 5 cats, adhesion between the conjunctiva and the cornea in 3 cats, and anterior synechia with corneal fibrosis in 2 cats. Regarding the unsuccessful outcome after conjunctival flap, the eyes lost their vision in 8 cats with collapsed anterior chamber, corneal fibrosis edema, and unresponsive endophthalmitis. The corneal wound healed completely in the 5 cats treated by corneal suturing with variable degrees of corneal edema and fibrosis. Saving the eye with perforated cornea could be achieved when an appropriate and rapid intervention is applied

PDF

___

1. Jhanji V, Young AL, Mehta JS, Sharma N, Agarwal T et al. Management of corneal perforation. Survey of Ophthalmology 2011; 56 (6): 522-538. doi: 10.1016/j.survophthal.2011.06.003
2. Goulle F. Use of porcine small intestinal submucosa for corneal reconstruction in dogs and cats: 106 cases. Journal of Small Animal Practice 2012; 53 (1): 34-43. doi: 10.1111/j.1748- 5827.2011.01149.x
3. Marfurt CF, Murphy CJ, Florczak JL. Morphology and neurochemistry of canine corneal innervation. Investigative Ophthalmology and Visual Science 2001; 42 (10): 2242-2251. PMID:11527937
4. Vasseinex C, Toubeau D, Brasseur G, Muraine M. Prise en charge des perforationscornéennes non traumatiques: étude rétrospective sur 8 ans. Journal Français d’Ophtalmologie 2006; 29 (7): 751-762. doi: 10.1016/S0181-5512(06)73844-x
5. Klatte JM, Dastjerdi MH, Clark K, Harrison CJ, Grigorian F et al. Hyperacute infectious keratitis with Plesiomonas shigelloides following traumatic lamellar corneal laceration. Pediatric Infectious Disease Journal 2012; 31: 1200-1201. doi: 10.1097/ INF.0b013e318266b61f
6. Bell CM, Pot SA, Dubielzig RR. Septic implantation syndrome in dogs and cats: a distinct pattern of endophthalmitis with lenticular abscess. Veterinary Ophthalmology 2013; 16: 180-185. doi:10.1111 /j.1463-5224.2012.01046.xEpub 2012 Jul 19
7. Chew HF, Jungkind DL, Mah DY, Raber IM, Toll AD et al. Posttraumatic fungal keratitis caused by Carpoligna species. Cornea 2010; 29: 449-452. doi: 10.1097/ICO.0b013e3181af3954
8. Davidson MG, Nelms SR. 23 Diseases of the lens and cataract formation. In: Gelatt KN (editor). Veterinary Ophthalmology. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 1999. pp. 797-825.
9. Brooks DE, Matthews AG. Equine ophthalmology. In: Gelatt KN (editor). Veterinary Ophthalmology. 4th ed. Ames, Iowa: Blackwell Publishing, 2007. pp. 1193-1212
10. Hollingsworth SR. Corneal surgical techniques. Clinical Technical Small Animal Practice 2003; 18: 161-167. doi: 10.1016/s1096- 2867(03)90012-0
11. Bussanich MN, Rootman J. Intraocular foreign body in a dog. Canadian Veterinary Journal 1981; 22: 207-210. ISSN 0008-5286.
12. Wilcock BP, Peiffer RL. The pathology of lens-induced uveitis in dogs. Veterinary Pathology 1987; 24 (6): 1549-1553. doi: 10.1177/030098588702400613
13. Grahn BH, Cullen CL. Equine phacoclastic uveitis: The clinical manifestations, light microscopic findings, and therapy of 7 cases. Canadian Veterinary Journal 2000; 41 (5): 376-382. PMCID: PMC1476266
14. Refojo MF, Dohlman CH, Ahmad B, Carroll JM, Allen JC. Evaluation of adhesives for corneal surgery. Archives of Ophthalmology 1986; 80 (5): 645-656. doi: 10.1001/archopht.1968.00980050647013
15. Sani ES, Kheirkhah A, Rana D, Sun Z, Foulsham W et al. Sutureless repair of corneal injuries using naturally derived bioadhesive hydrogels. Science Advances 2019; 5 (3): 1-14. doi: 10.1126/sciadv.aav1281
16. Lacerda RP, Peña Gimenez MT, Laguna F, Costa D, Rios J et al. Corneal grafting for the treatment of full-thickness corneal defects in dogs: a review of 50 cases. Veterinary Ophthalmology 2017; 20 (3): 222-231. doi: 10.1111/vop.12392.
17. Dorbandt DM, Moore PA, Myrna KE. Outcome of conjunctival flap repair for corneal defects with and without an acellular submucosa implant in 73 canine eyes. Veterinary Ophthalmology 2015; 18 (2): 116-122. doi: 10.1111/vop.12193
18. Hansen PA, Guandalini A. A retrospective study of 30 cases of frozen lamellar corneal graft in dogs and cats. Veterinary Ophthalmology 1999; 2 (4): 233-241. doi: 10.1046/j.1463- 5224.1999.00084.x
19. Dulaurent T, Azoulay T, Goulle F, Dulaurent A, Mentek M et al. Use of bovine pericardium (Tutopatch®) graft for surgical repair of deep melting corneal ulcers in dogs and corneal sequestra in cats. Veterinary Ophthalmology 2014; 17 (2): 91- 99. doi: 10.1111/vop.12047
20. Brightbill FS, Brass RE. Preoperative evaluation of the keratoplasty patient. In: Kachmer JH, Mannis MJ, Holland EJ (editors). Cornea: Surgery of the Cornea and Conjunctiva. 3rd ed. St. Louis: Mosby-Year Book; 1997.
21. Sarangom SB, Baburaj NK, D’Sa ET, Venugopal SK. Surgical repair of corneal laceration complicated by iris inclusion in a dog. Veterinary World 2012; 5 (10): 631-633. doi: 10.5455/ vetworld.2012.631-633
22. Severin GA. Cornea. In: Severin GA. Severin’s Veterinary Ophthalmology Notes. 3rd ed. Fort Collins: CSU Press; 1995.
23. Wilkie W. Viscoelastic materials in veterinary ophthalmology. Veterinary Ophthalmology 1999; 2 (3): 147-153. doi: 10.1046/j.1463-5224.1999.00076.x
24. Spiess BM, Fuhli MR, Bollinger J. Eye injuries from cats claw at dog. Schweizer Archiv für Tierheilkunde 1996; 138 (9): 429- 433 (in German).
25. Mancuso LA., Lassaline M, Scherrer NM. Porcine urinary bladder extracellular matrix grafts (ACell Vet Corneal Discs) for keratomalacia in 17 equids (2012-2013). Veterinary Ophthalmology 2016; 19 (1): 3-10. doi: 10.1111/vop.12240
26. Saini JS, Sharma A, Grewal SP. Chronic corneal perforations. Ophthalmic Surgery 1992; 23 (6): 399-402.
27. Lassaline ME, Brooks DE, Ollivier FJ, Komaromy AM, Kallberg ME et al. Equine amniotic membrane transplantation for corneal ulceration and keratomalacia in three horses. Veterinary Ophthalmology 2005; 8 (5): 311-317. doi: 10.1111/j.1463-5224.2005.00405.x
28. Kim SY, Kim JY, Jeong SW. Long-term evaluation of autologous lamellar corneal grafts for the treatment of deep corneal ulcer in four dogs: a case report. Veterinarni Medicina 2019; 64: 84- 91. doi.org/10.17221/139/2017
29. Anderson JM, Rodriguez A, Chang DT. Foreign body reaction to biomaterials. Seminars in Immunology 2008; 20 (2): 86-100. doi: 10.1016/j.smim.2007.11.004
30. Hick S, Demers PE, Brunette I, La C, Mabon M et al. Amniotic membrane transplantation and fibrin glue in the management of corneal ulcers and perforations: a review of 33 cases. Cornea 2005; 24 (4): 369-377. doi:10.1097/01.ico.0000151547.08113. d1
31. Mieszawska AJ, Kaplan DL. Smart biomaterials-regulating cell behavior through signaling molecules. BMC Biology 2010; 8: 59-61. doi: 10.1186/1741-7007-8-59
32. Tuntivanich P, Tuntivanich N, Soontornvipart K. Cornea. In: Tuntivanich P (editor). Veterinary Ophthalmology. 2nd ed. Chulalongkorn University, Bangkok, 2001. pp. 95-120