Use of Conjunctival Pedicle Grafts to Treat Corneal Diseases in the
Horse. Retrospective Review of 26 Cases
Abstract
Background There are limited data on outcomes and complications
of conjunctival pedicle grafts in horses. Objective Document
the indications, complications and outcomes of conjunctival pedicle
grafts in horses. Study Design Retrospective case series.
Methods Review of case records of horses with corneal diseases
managed using conjunctival pedicle grafts. History, clinical findings,
treatments, complications, and outcomes were recorded. Results
26 horses were treated by conjunctival pedicle grafts over a 16 years
period. The indications were deep corneal ulceration (n=9), non-healing
superficial corneal ulceration (n=6), corneal stromal abscessation
(n=5), corneal laceration (n=3) and keratomalacia (n=3). Short term
complications occurred in 12 horses (46%), the commonest being necrosis
of the graft (n=6); in 3 cases, the corneal lesion healed following
debridement, but in 2 the affected eye required enucleation and one was
euthanased. Keratomalacia and ulceration extending beyond the graft
occurred in 3 horses, all of which were enucleated. Uveitis occurred in
6 horses (4 cases prior to discharge and 2 after discharge); enucleation
was required in 5 of these horses. Phthisis bulbi occurred prior to
discharge in one horse and after discharge in another. Two horses had
decreased faecal output after surgery (one had caecal impaction). In
6/26 cases (23%) enucleation was required prior to hospital discharge.
One horse was euthanased due to post-operative caecal impaction. The
short-term success rate was 69%. Two horses (8%) required enucleation
after discharge from the hospital and the long-term success rate was
58%. Main Limitations Small number of cases with variety of
different diseases of varying severities. Conclusions
Conjunctival pedicle grafts were successfully employed to treat several
corneal diseases including chronic superficial corneal ulceration, deep
corneal ulceration, corneal stromal abscesses, corneal lacerations and
keratomalacia. The short-term success rate was 69%. Long-term follow-up
indicated a good prognosis for most horses that had a successful
short-term outcome.