Dulaurent Thomas, Azoulay Thierry, Goulle Frédéric, Dulaurent Alice, Mentek Marielle, Peiffer Robert L, Isard Pierre-François
Centre Hospitalier Vétérinaire, 275 Route Impériale, Saint-Martin Bellevue, 74370, France.
Vet Ophthalmol. 2014 Mar;17(2):91-9. doi: 10.1111/vop.12047. Epub 2013 Apr 28.
To evaluate the efficacy of bovine pericardium (BP) graft in the treatment of deep melting corneal ulcers in three dogs and corneal sequestra in three cats.
Three dogs with keratomalacia affecting the deep third of the stroma and three cats with corneal sequestrum were evaluated and underwent surgery. Following keratectomy, BP material was placed into the keratectomy bed and sutured to the recipient cornea with 9/0 polyglactin suture material. Postoperative treatment with topical and systemic antibiotics, systemic nonsteroidal anti-inflammatory agents, and topical atropine was prescribed. Follow-up examinations were carried out 1, 2 weeks, 1 and 2 months after the surgery and consisted of a complete ophthalmic examination. Optical coherence tomography (OCT) was performed 1 and 2 months after the surgery in one dog and in one cat.
At 1 week, corneal neovascularization was present around the BP graft in all cases. Four weeks after the BP graft, in two dogs and in all cats, the vascularization was regressing and the graft was integrated into the cornea, which was regaining transparency. Topical treatment with anti-inflammatory agents was then prescribed for 2 weeks. Two months after the surgery, 5 of 6 corneas in two dogs and three cats had healed with focal corneal scarring. The remaining dog had progression of the keratomalacia involving the deep BP graft that required additional surgery, but became blind.
Bovine pericardium graft offers a promising option for surgical reconstruction of the cornea following keratectomy for the management of corneal ulcers and sequestra.
评估牛心包(BP)移植片治疗3只犬的深层溶解性角膜溃疡和3只猫的角膜腐骨的疗效。
对3只基质深层受影响的软化角膜犬和3只角膜腐骨猫进行评估并实施手术。角膜切除术后,将BP材料置于角膜切除床上,并用9/0聚乙醇酸缝线材料缝合至受体角膜。术后给予局部和全身抗生素、全身非甾体抗炎药以及局部阿托品治疗。术后1周、2周、1个月和2个月进行随访检查,包括完整的眼科检查。1只犬和1只猫在术后1个月和2个月进行了光学相干断层扫描(OCT)。
术后1周,所有病例的BP移植片周围均出现角膜新生血管。BP移植片植入4周后,2只犬和所有猫的新生血管消退,移植片与角膜整合,角膜恢复透明。随后给予抗炎药局部治疗2周。术后2个月,2只犬和3只猫的6只角膜中有5只愈合,伴有局限性角膜瘢痕形成。其余1只犬的软化角膜进展累及深层BP移植片,需要再次手术,但最终失明。
对于角膜溃疡和角膜腐骨切除术后的角膜手术重建,牛心包移植片是一种有前景的选择。