TY - JOUR
T1 - Superficial keratectomy and conjunctival advancement hood flap (SKCAHF) for the management of bullous keratopathy
T2 - Validation in dogs with spontaneous disease
AU - Horikawa, Taemi
AU - Thomasy, Sara M
AU - Stanley, Amelia A.
AU - Calderon, Allison S.
AU - Li, Jennifer
AU - Linton, Lana L.
AU - Murphy, Christopher J
PY - 2016
Y1 - 2016
N2 - Purpose: To evaluate the efficacy of superficial keratectomy and conjunctival advancement hood flap (SKCAHF) for the treatment of bullous keratopathy in canine patients. Methods: Nine dogs (12 eyes) diagnosed with progressive corneal edema underwent superficial keratectomy followed by placement of conjunctival advancement hood flaps. The canine patients were examined pre- and postoperatively using in vivo confocal microscopy, ultrasonic pachymetry (USP), and Fourier-domain optical coherence tomography (FD-OCT). All owners responded to a survey regarding treatment outcomes. Results: Mean central corneal thickness (CCT) as measured by FDOCT was 1163 ± 290 mm preoperatively and significantly decreased postoperatively to 795 ± 197 mm (P = 0.001), 869 ± 190 mm (P = 0.005), and 969 ± 162 mm (P = 0.033) at median postoperative evaluations occurring at 2.2, 6.8, and 12.3 months, respectively. Owners reported significant improvement (P < 0.05) in vision and corneal cloudiness at 6.8 and 12.3 months postoperatively. The percentage of cornea covered by the conjunctival flap was correlated (P = 0.0159) with a reduction in CCT by USP at 12.3 months postoperatively. All canine patients were comfortable pre- and postoperatively. Conclusions: SKCAHF results in a reduction of corneal thickness in canine patients with bullous keratopathy. The increase in corneal thickness over time, after performing SKCAHF, is likely because of progressive endothelial decompensation. This surgery is a potentially effective intervention for progressive corneal edema in dogs that may have value in treatment of human patients with bullous keratopathy.
AB - Purpose: To evaluate the efficacy of superficial keratectomy and conjunctival advancement hood flap (SKCAHF) for the treatment of bullous keratopathy in canine patients. Methods: Nine dogs (12 eyes) diagnosed with progressive corneal edema underwent superficial keratectomy followed by placement of conjunctival advancement hood flaps. The canine patients were examined pre- and postoperatively using in vivo confocal microscopy, ultrasonic pachymetry (USP), and Fourier-domain optical coherence tomography (FD-OCT). All owners responded to a survey regarding treatment outcomes. Results: Mean central corneal thickness (CCT) as measured by FDOCT was 1163 ± 290 mm preoperatively and significantly decreased postoperatively to 795 ± 197 mm (P = 0.001), 869 ± 190 mm (P = 0.005), and 969 ± 162 mm (P = 0.033) at median postoperative evaluations occurring at 2.2, 6.8, and 12.3 months, respectively. Owners reported significant improvement (P < 0.05) in vision and corneal cloudiness at 6.8 and 12.3 months postoperatively. The percentage of cornea covered by the conjunctival flap was correlated (P = 0.0159) with a reduction in CCT by USP at 12.3 months postoperatively. All canine patients were comfortable pre- and postoperatively. Conclusions: SKCAHF results in a reduction of corneal thickness in canine patients with bullous keratopathy. The increase in corneal thickness over time, after performing SKCAHF, is likely because of progressive endothelial decompensation. This surgery is a potentially effective intervention for progressive corneal edema in dogs that may have value in treatment of human patients with bullous keratopathy.
KW - Bullous keratopathy
KW - Canine corneal endothelial dystrophy
KW - Conjunctival flap
KW - Corneal edema
KW - Fuchs endothelial corneal dystrophy
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U2 - 10.1097/ICO.0000000000000966
DO - 10.1097/ICO.0000000000000966
M3 - Article
C2 - 27538190
AN - SCOPUS:84983070819
VL - 35
SP - 1295
EP - 1304
JO - Cornea
JF - Cornea
SN - 0277-3740
IS - 10
ER -