한국임상수의학회지 (Journal of Veterinary Clinics)

  • 제40권2호
  • /
  • Pages.152-157
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  • 2023
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  • 1598-298X(pISSN)
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  • 2384-0749(eISSN)
한국임상수의학회 (The Korean Society of Veterinary Clinics)
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"Letter-Box" Conjunctival Flap in a Dog with Severe Corneal Edema after Phacoemulsification

  • Sunhyo Kim (Department of Ophthalmology, Ilsan Animal Medical Center) ;
  • Dohyoung Kwon (Department of Ophthalmology, Ilsan Animal Medical Center) ;
  • Kangmoon Seo (Department of Veterinary Clinical Sciences, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University) ;
  • Seonmi Kang (Department of Veterinary Clinical Sciences, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University)
  • 투고 : 2022.12.26
  • 심사 : 2023.04.10
  • 발행 : 2023.04.30
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초록

A two-year-old, spayed female, Bichon Frise, was referred for severe corneal edema and corneal ulcer in the left eye (OS). The cornea had gradually swelled over one week after phacoemulsification performed a month prior, and that was refractory to 5% sodium chloride eye drop instillation or temporary partial tarsorrhaphy. A complete ophthalmic examination was performed. Severe corneal edema with intrastromal bullae and moderate anterior chamber flare was found on slit-lamp biomicroscopy in the OS, which obstructed the fundus examination. Corneal thickness was measured using high-resolution ultrasound biomicroscopy. The thickness of the OS cornea was 2.74 mm. The "letter-box" conjunctival flap was planned. Dorsal and ventral superficial keratectomy followed by a hood conjunctival flap was performed. Topical and systemic antibiotics and 5% sodium chloride eye drops were prescribed. Decreased corneal thickness was observed at one week, two weeks, and two months postoperatively (1.53 mm, 1.32 mm, and 0.92 mm, respectively). There were no postoperative complications, such as ocular discomfort or recurrent corneal ulcers. The "letter-box" conjunctival flap, a type of superficial keratectomy and conjunctival advancement hood flap, effectively relieved the severe irreversible corneal edema. This could be a simple but effective surgical intervention for patients with endothelial cell damage especially after phacoemulsification.

키워드

과제정보

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2021R1I1A1A01058695). In addition, the authors gratefully acknowledge the financial and facility support of the director of the Ilsan animal medical center, Woong-ju Chae.

참고문헌

  1. Armour MD, Askew TE, Eghrari AO. Endothelial keratoplasty for corneal endothelial dystrophy in a dog. Vet Ophthalmol 2019; 22: 545-551. https://doi.org/10.1111/vop.12670
  2. Boo G, Whittaker CJG, Caruso KA, Moloney G, Hall E, Devasahayam R, et al. Early postoperative results of Descemet's stripping endothelial keratoplasty in six dogs with corneal endothelial dystrophy. Vet Ophthalmol 2019; 22: 879-890. https://doi.org/10.1111/vop.12666
  3. Donaldson D, Hartley C. Ophthalmic examination and diagnostics. Part 2: ocular imaging. In: Gelatt KN, Ben-Shlomo G, Gilger BC, Hendrix DVH, Kern TJ, Plummer CE, editors. Veterinary ophthalmology. 6th ed. Ames: Blackwell Publishing. 2021: 662-732.
  4. Dubielzig R, Ketring K, McLellan G, Albert D. Diseases of the cornea and sclera. In: Dubielzig R, Ketring K, McLellan G, Albert D, editors. Veterinary ocular pathology: a comparative review. Philadelphia: Elsevier-Saunders. 2010: 201-243.
  5. Gelatt KN, Brooks DE. Surgery of the cornea and sclera. In: Gelatt KN, Gelatt JP, editors. Veterinary ophthalmic surgery. Maryland Height: Elsevier Saunders. 2011: 191-236.
  6. Gelatt KN, Wilkie DA. Surgical procedures of the lens and cataract. In: Gelatt KN, Gelatt JP, editors. Veterinary ophthalmic surgery. Maryland Height: Elsevier Saunders. 2011: 305-355.
  7. Giannikaki S, Escanilla N, Sturgess K, Lowe RC. A modified technique of keratoleptynsis ("letter-box") for treatment of canine corneal edema associated with endothelial dysfunction. Vet Ophthalmol 2020; 23: 930-942. https://doi.org/10.1111/vop.12823
  8. Horikawa T, Thomasy SM, Stanley AA, Calderon AS, Li J, Linton LL, et al. Superficial keratectomy and conjunctival advancement hood flap (SKCAHF) for the management of bullous keratopathy: validation in dogs with spontaneous disease. Cornea 2016; 35: 1295-1304. https://doi.org/10.1097/ICO.0000000000000966
  9. Kim Y, Nam S, Kang S. Clinical features and outcomes of superficial keratectomy and conjunctival advancement hood flap in three dogs with different extents of corneal edema. J Vet Clin 2021; 38: 98-102. https://doi.org/10.17555/jvc.2021.04.38.2.98
  10. Knezovic I, Dekaris I, Gabric N, Cerovski J, Barisic A, Bosnar D, et al. Therapeutic efficacy of 5% NaCl hypertonic solution in patients with bullous keratopathy. Coll Antropol 2006; 30: 405-408.
  11. Maggs DJ. Diseases of the cornea and sclera. In: Maggs DJ, Miller P, Ofri R, editors. Slatter's fundamentals of veterinary ophthalmology. 6th ed. Saint Louis: Elsevier. 2018: 213-253.
  12. Mayes MA, Casanova MI, Park S, Steele K, Linton L, Kim S, et al. Canine endotheliitis: clinical characteristics, advanced imaging features, and treatment. Vet Ophthalmol 2022; 25(Suppl 1): 185-192. https://doi.org/10.1111/vop.12967
  13. Michau TM. Surgery of the lens. In: Gelatt KN, Ben-Shlomo G, Gilger BC, Hendrix DVH, Kern TJ, Plummer CE, editors. Veterinary ophthalmology. 6th ed. Ames: Blackwell Publishing. 2021: 1371-1458.
  14. Michau TM, Gilger BC, Maggio F, Davidson MG. Use of thermokeratoplasty for treatment of ulcerative keratitis and bullous keratopathy secondary to corneal endothelial disease in dogs: 13 cases (1994-2001). J Am Vet Med Assoc 2003; 222: 607-612. https://doi.org/10.2460/javma.2003.222.607
  15. Okumura N, Kinoshita S, Koizumi N. The role of rho kinase inhibitors in corneal endothelial dysfunction. Curr Pharm Des 2017; 23: 660-666. https://doi.org/10.2174/1381612822666161205110027
  16. Okumura N, Sakamoto Y, Fujii K, Kitano J, Nakano S, Tsujimoto Y, et al. Rho kinase inhibitor enables cell-based therapy for corneal endothelial dysfunction. Sci Rep 2016; 6: 26113.
  17. Sanchez RF. The cornea. In: Gould D, McLellan GJ, editors. BSAVA manual of canine and feline ophthalmology. 3rd ed. Gloucester: BSAVA. 2014: 200-231.
  18. Scherrer NM, Lassaline M, Miller WW. Corneal edema in four horses treated with a superficial keratectomy and Gundersen inlay flap. Vet Ophthalmol 2017; 20: 65-72. https://doi.org/10.1111/vop.12342
  19. Whitley RD, Hamor RE. Diseases and surgery of the canine cornea and sclera. In: Gelatt KN, Ben-Shlomo G, Gilger BC, Hendrix DVH, Kern TJ, Plummer CE, editors. Veterinary ophthalmology. 6th ed. Ames: Blackwell Publishing. 2021: 1082-1172.