The Use of 360-Degree Conjunctival Graft and Biomaterials in the Treatment of Extensive Corneal Ulceration and Keratomalacia in Dogs: Nine Cases.

Abstract

OBJECTIVE: To evaluate the use of a 360-degree conjunctival graft in combination with three different biomaterials: amniotic membrane (AM), porcine small intestinal submucosa (SIS), and porcine urinary bladder acellular matrix (UBM) in dogs with extensive keratomalacia. MATERIAL AND METHODS: Medical records from a single referral center were retrospectively reviewed. Dogs with extensive keratomalacia affecting at least 50% of the corneal diameter that underwent a 360-degree conjunctival graft in combination with a biomaterial (AM, SIS, UBM) were included. RESULTS: Nine eyes from nine dogs were included. The mean horizontal percentage of the malacic cornea was 68.4% and mean vertical percentage was 67.7%. Ulcer depth ranged from > 70% stromal (66.7%), descemetocele (22.2%), and corneal perforation (11.1%). Mean follow-up time was 153 days (range: 17-483 days). Successful corneal healing and globe retention was achieved in 8/9 eyes (88.9%). Of the preserved globes, 7/8 eyes (87.5%) were visual at the last follow-up. CONCLUSIONS: The use of a 360-degree conjunctival graft in combination with AM, SIS, or UBM for the treatment of melting ulcers affecting > 50% of the corneal surface resulted in excellent globe and vision retention rates. Significant and profound corneal vascularization, granulation tissue, fibrosis, and edema were noticed in most cases following the release of the 360-degree conjunctival graft, which reduced over time.