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犬穿透性角膜移植术应用去细胞猪角膜基质(BioCorneaVet™):五例前瞻性初步研究。

Penetrating Keratoplasty in Dogs using Acellular Porcine Corneal Stroma (BioCorneaVet™): A prospective pilot study of five cases.

机构信息

Ophthalmology Unit, Vetsuisse Faculty, Equine Department, University of Zurich, Zurich, Switzerland.

Section of Epidemiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.

出版信息

Vet Ophthalmol. 2021 Sep;24(5):543-553. doi: 10.1111/vop.12884. Epub 2021 Mar 28.

Abstract

OBJECTIVE

This prospective pilot study was conducted to evaluate the outcome of a commercially available corneal stroma substitute, Acellular Porcine Corneal Stroma (APCS), in dogs undergoing penetrating keratoplasty (PK) to restore corneal integrity after having deep ulcers.

METHOD

Five dogs (1 eye in each dog) underwent a PK using APCS (BioCorneaVet™) as a graft. The surgical procedure and peri- and postoperative treatment were standardized. All cases required a minimum 6 months follow-up. Ease of keratoprosthetic tissue handling, graft survival, anterior chamber stability, corneal opacity, neovascularization and re-epithelialization were noted. Presence of secondary uveitis was investigated.

RESULTS

BioCorneaVet™ was easy to handle and, at all-time points, provided adequate tectonic support. Graft survival was achieved in all 5 cases. A minimum follow-up period of 10 months was available for the five eyes (22 months maximum). Degree and area of corneal graft opacity progressively improved resulting in minimal to moderate loss of transparency in all cases but one, where it was severe. Neovascularization degree was most severe 0.5-1 month after surgery and fully resolved 4-6 months post-surgery. Re-epithelialization was complete in the majority of grafts in 1 month. Secondary uveitis was not detected at any time in 4 of 5 dogs.

CONCLUSION

BioCorneaVet™ seems to be an effective graft for PK in the dog. In this case series, APCS was convenient to handle during surgery and provided excellent tectonic support. The material showed good tissue biocompatibility and resulted in the majority of cases in minimal to moderate graft opacity, that ameliorates with time.

摘要

目的

本前瞻性初步研究旨在评估一种市售的角膜基质替代品——脱细胞猪角膜基质(APCS)在犬穿透性角膜移植(PK)中的疗效,以恢复深度溃疡后角膜完整性。

方法

5 只狗(每只狗 1 只眼)接受了使用 APCS(BioCorneaVet™)作为移植物的 PK。标准化了手术程序和围手术期治疗。所有病例均需至少 6 个月的随访。记录了角膜移植物的处理难度、移植物存活率、前房稳定性、角膜混浊、新生血管形成和再上皮化。调查了是否存在继发性葡萄膜炎。

结果

BioCorneaVet™易于操作,在所有时间点均提供足够的结构支撑。5 例均实现了移植物存活。5 只眼的最短随访时间为 10 个月(最长随访时间为 22 个月)。所有病例(除 1 例外)的角膜移植物混浊程度和面积均逐渐改善,导致不同程度的透明度丧失,其中 1 例为严重丧失。新生血管形成程度在术后 0.5-1 个月最为严重,术后 4-6 个月完全消退。大多数移植物在 1 个月内完全上皮化。4 只狗在任何时间均未发现继发性葡萄膜炎。

结论

BioCorneaVet™似乎是犬 PK 的一种有效移植物。在本病例系列中,APCS 在手术中易于操作,并提供了极好的结构支撑。该材料显示出良好的组织生物相容性,大多数病例的移植物混浊程度为轻度至中度,随着时间的推移会逐渐改善。

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