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Modified penetrating keratoplasty with Acell ® bioscaffold implant in seven horses with deep full‐thickness corneal stromal abscess
Author(s) -
Cichocki Brian M.,
Myrna Kathern E.,
Moore Phillip A.
Publication year - 2017
Publication title -
veterinary ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.594
H-Index - 50
eISSN - 1463-5224
pISSN - 1463-5216
DOI - 10.1111/vop.12349
Subject(s) - medicine , implant , surgery , cornea , ophthalmology , stromal cell , pathology
Objective To describe and evaluate a modified penetrating keratoplasty technique utilizing AC ell ® for management of equine deep stromal or full‐thickness corneal stromal abscesses ( SA ). Methods Cases presenting to the University of Georgia Ophthalmology service for surgical management of SA necessitating penetrating keratoplasty ( PK ) were included in the study population. Surgery entailed the use of an AC ell ® disk sutured within the deep level of a stepped full‐thickness corneal incision with an overlying conjunctival pedicle flap placed in the superficial step incision. Patients were evaluated for success as defined by a comfortable, visual outcome. Results Surgery was performed in seven horses. Conjunctival flap incorporation and globe retention occurred in all patients. Functional vision was maintained in six of seven eyes (85.7%) at last follow‐up examination (mean of 87.6 days [range 41–251 days]). Mean size of AC ell ® implant was six millimeters (range 4–8 mm). Postoperative complications included moderate to severe anterior uveitis ( n = 2), diffuse keratitis ( n = 1), incipient cataract formation ( n = 3), and anterior and posterior synechiae ( n = 1). Conclusions This technique is a viable option for treatment of equine SA requiring PK . The use of bioscaffold implant is an alternative to frozen and fresh donor cornea transplantation.