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. 2020 Nov;23(6):930-942.
doi: 10.1111/vop.12823. Epub 2020 Sep 6.

A modified technique of keratoleptynsis ("letter-box") for treatment of canine corneal edema associated with endothelial dysfunction

Stamatina Giannikaki  1 , Natalia Escanilla  1 , Kit Sturgess  2 , Robert C Lowe  1
Affiliations

A modified technique of keratoleptynsis ("letter-box") for treatment of canine corneal edema associated with endothelial dysfunction

Stamatina Giannikaki et al. Vet Ophthalmol. 2020 Nov.

Abstract

Purpose: To describe a modified keratoleptynsis procedure, as a method of preserving central corneal function, and evaluate the outcome in vision, reduction of corneal thickness and treatment of epithelial corneal ulcers in cases with endothelial cell dysfunction.

Methods: Forty-four dogs (72 eyes) were affected by progressive corneal edema, with or without ulcerative keratitis. All patients were treated with a dorsal and ventral superficial keratectomy followed by conjunctival flaps, maintaining a clear central cornea. Corneal thickness measurements were obtained via ultrasound biomicroscopy.

Results: All eyes showed resolution of ocular discomfort postoperatively, with a median time to resolution of 35 days. Two years post-surgery, vision had been lost in 2 of 29 eyes (7%). From the initial population, 23 dogs (39 eyes) had follow-up evaluations of corneal thickness. The mean central corneal thickness was 1359 ± 251 μm prior to surgery. Thickening of the central cornea was observed one week after surgery to 1559 ± 263 μm. Decreased corneal thickness was reported, at 1 month, 4 months, 10 months and 2 years postoperatively (1285 ± 267 μm, 1102 ± 150 μm, 1121 ± 288 μm, 1193 ± 283 μm, respectively). All eyes showed a similar trend of increasing and then decreasing corneal thickness.

Conclusions: This surgical technique provided statistically significant reduction in central corneal thickness and sustained relief of ocular pain. Reduction in corneal thickness appeared to be maintained 2 years post-surgery, and all patients remained comfortable. Superficial corneal pigmentation and fibrosis resulted in vision loss in two eyes.

Keywords: conjunctival flap; corneal edema; corneal endothelial degeneration; corneal endothelial dystrophy; keratectomy; keratoleptynsis.

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References

REFERENCES

    1. Gelatt KN, Gilger BC, Kern TJ. Veterinary ophthalmology. Ames, IA: Wiley-Blackwell; 2013.
    1. Gwin RM, Lerner I, Warren JK. Decrease in canine corneal endothelial cell density and increase in corneal thickness as functions of age. Invest Ophthalmol Vis Sci. [Association for Research in Vision and Ophthalmology, etc.]; 1982;22:267-271.
    1. Shull OR, Reilly CM, Davis LB, Murphy CJ, Thomasy SM. Phenotypic characterization of corneal endothelial dystrophy in german shorthaired and wirehaired pointers using in vivo advanced corneal imaging and histopathology. Cornea. 2018;37(1):88-94.
    1. Thomasy SM, Cortes DE, Hoehn AL, Calderon AC, Li JY, Murphy CJ. In vivo imaging of corneal endothelial dystrophy in boston terriers: a spontaneous, canine model for Fuchs’ endothelial corneal dystrophy. Invest Ophthalmol Vis Sci. 2016;57(9):495-503.
    1. Auten CR, Thomasy SM, Kass PH, Good KL, Hollingsworth SR, Maggs DJ. Cofactors associated with Sudden Acquired Retinal Degeneration Syndrome: 151 dogs within a reference population. Vet Ophthalmol. 2017;21(3):264-272.

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