Coronofrontal rhytidectomy: A new approach for the treatment of severe pseudoptosis and superior entropion in dogs.

PURPOSE: To describe the use of coronofrontal rhytidectomy (CFR) for the treatment of severe pseudoptosis and superior entropion in dogs, and to provide guidelines for the selection of surgical technique depending on presentation. METHODS: A review of medical records of dogs that underwent rhytidectomy from 2002 to 2023 was carried out, including signalment, clinical signs, type of rhytidectomy, concurrent surgical techniques, re-interventions, post-operative complications, follow-up time, and outcome. RESULTS: Twenty dogs with a median age of 5.1 years were included in this study. English Cocker Spaniel was the most common breed (8 dogs:40%) and males were overrepresented (13 dogs: 65%). Besides pseudoptosis and visual impairment (100%), the other most common clinical signs were entropion and/or ectropion (19 dogs: 95%), conjunctivitis (17 dogs: 85%), euryblepharon (12 dogs: 60%) and non-ulcerative keratitis (10 dogs: 50%). CFR was performed in 12 dogs (60%), frontal rhytidectomy in 5 (25%), coronal in 2 (10%), and modified shared in 1 (5%). Concurrent surgical techniques were performed in 17 dogs (85%), being lateral canthoplasty (13 dogs; 65%), and Celsus-Hotz (10 dogs; 50%) the most common. The median follow-up time was 115 days with no complications and good outcomes reported in all dogs. At last re-recheck, complete correction of the eyelid positioning was obtained in 92% (11/12) and 87.5% (7/8) of the cases that underwent CFR and other rhytidectomy techniques, respectively. CONCLUSION: CFR is an effective surgical treatment for severe pseudoptosis and superior entropion in dogs. The provided guidelines will assist in the selection of the most appropriate eyelid lifting technique.

Treatment outcome of spontaneous chronic corneal epithelial defects in brachycephalic dogs comparing Boxers and non-Boxers: A retrospective multicenter study of 420 dogs.

OBJECTIVE: To compare characteristics and treatment outcomes of spontaneous chronic corneal epithelial defects (SCCEDs) in brachycephalic non-Boxers and Boxers. We hypothesized that brachycephalic non-Boxers develop SCCEDs at a younger age and develop complications more frequently than Boxers. ANIMALS STUDIED: Retrospective review of medical records of brachycephalic dogs treated for SCCEDs between January 2018 and December 2022 in multiple ophthalmology referral centers in the UK. PROCEDURE: Data recorded included breed, age, time of onset, treatment prior to referral, treatment at referral, time to heal, need for further procedures, and complications. RESULTS: A total of 464 SCCEDs in 420 dogs were included composed of 173 Boxers with 200 SCCEDs and 247 brachycephalic non-Boxer dogs with 264 SCCEDs. Boxers were significantly older (median 8.2, range 4.5-12.7 years) than brachycephalic non-Boxers (median 7.2, range 1.6-15.9 years) (p < .001). The first treatment (cotton-tipped applicator [CTA] debridement, diamond burr debridement, superficial keratectomy, grid keratotomy, punctate keratotomy, or combinations of these) selected was significantly different between groups (p < .001). Healing, excluding cases addressed by CTA debridement, following the first procedure was significantly more successful in Boxers (p = .049). Excluding cases addressed by CTA debridement, 9.6% of SCCEDs in Boxers (20/200) and 13.4% (32/239) of non-Boxers required more than one procedure. In the non-Boxer group, 9.5% (25/264) developed complications, contrasting with 4% (8/200) in the Boxer group. Non-Boxers were more likely to develop complications after the first treatment (p = .006). CONCLUSION: Non-Boxer brachycephalic dogs develop SCCEDs younger than Boxers. This study suggests SCCEDs in brachycephalic non-Boxers may be less likely to heal following one mechanical treatment and are more likely to develop complications.

Corneoconjunctival transposition for the treatment of deep stromal to full-thickness corneal defects in dogs: A multicentric retrospective study of 100 cases (2012-2018).

OBJECTIVE: To describe and evaluate the use of corneoconjunctival transposition (CTT) as a surgical treatment for canine deep stromal ulcers, descemetoceles, and full-thickness corneal defects and to determine its efficacy in preserving corneal graft transparency and vision. ANIMALS STUDIED: One hundred client-owned dogs with deep stromal ulcers, descemetoceles, or full-thickness corneal defects. METHODS: Medical records of canine patients that underwent CCT, from 2012 to 2018, were reviewed. Only, patients with preoperative positive consensual pupillary light and dazzle reflexes were included. RESULTS: There were 59 males and 41 females, from 0.3 to 17 years. Brachycephalic breeds were overrepresented (65%). All patients were unilaterally affected, with 16 deep stromal ulcers, 33 descemetoceles, and 51 corneal perforations, of a median (range) size of 4 (2-8) mm. The central cornea was affected in the majority of cases (57%), and euryblepharon and keratoconjunctivitis sicca were the most common concurrent ocular diseases (42% and 40%, respectively). The graft was most frequently harvested from dorsal (67%), and 9/0 absorbable suture material was used. Intraoperative and postoperative complications were seen in 7 and 21 cases, respectively. Mean follow-up time was 107.8 days. Vision was preserved in 96% patients, with 62% showing faint to mild opacification. Among the statistically analyzed variables, euryblepharon and pigmentary keratitis were found to be significantly associated with greater corneal graft opacification (P = .040 and P = .028, respectively). CONCLUSIONS: Corneoconjunctival transposition is an effective surgical treatment for deep stromal, descemetocele, and full-thickness corneal defects in dogs, achieving a highly satisfactory degree of corneal graft transparency and preserving vision.

Corneal grafting for the treatment of full-thickness corneal defects in dogs: a review of 50 cases.

OBJECTIVE: To describe corneal grafting for the treatment of full-thickness corneal defects in dogs and to determine its effectiveness in preserving vision. METHODS: A review of the medical records of dogs that underwent corneal grafting following corneal perforations (≥3 mm) at the VTH-UAB from 2002 to 2012 was carried out. RESULTS: Fifty dogs of different breed, age and gender were included. Brachycephalic breeds were overrepresented (37/50;74%). All cases were unilateral, with euryblepharon being the most common concurrent ocular abnormality (20/50;40%). Full-thickness penetrating keratoplasties (FTPK) were performed in 21/50 eyes (42%) and lamellar keratoplasties (LK) in 29/50 eyes (58%). Frozen grafts (FroG) were used in 43/50 eyes (86%) and fresh homologous grafts (FreHoG) in 7/50 (14%). Of the former group, 26 were homologous (FroHoG:60%) and 17 heterologous (FroHeG:40%). A combination of topical medication (antibiotics, corticosteroids, cycloplegics, and 0.2% cyclosporine A) and systemic mycophenolate mofetil was administered. Median follow-up time was 200 days. Postsurgical complications included wound dehiscence (6/50;12%) and glaucoma (4/50;8%). Clinical signs of graft rejection were diagnosed as follows: FroHoG (13/26;50%), FroHeG (11/17;65%), FreHoG (4/7;57%), FTPK (12/21;57%), and LK (16/29;55%). Medical treatment successfully controlled graft rejection in 11/28 eyes (39%). Good anatomical outcome was achieved in 86% (43/50), of which 95% (41/43) were visual at last examination, with moderate opacification to complete transparency of the graft present in 48.2%. CONCLUSIONS: Corneal grafting is an effective surgical treatment for full-thickness corneal defects in dogs. If graft rejection is present, additional medical or surgical therapy may be necessary, achieving a highly satisfactory visual outcome.

A comparative study of corneal sensitivity in birds of prey.

OBJECTIVE: To determine and compare the corneal sensitivity in healthy wild diurnal and nocturnal birds of prey (BP) indigenous to Catalonia (Spain), and to establish if age is a determining factor in corneal sensitivity in those species. METHODS: Ophthalmic examination was performed in 105 BP. Only birds with no ocular abnormalities were included in the study (n = 81): 21 diurnal BP (Falco tinnunculus: 16 fledglings, 5 adults) and 60 nocturnal BP (20 Athene noctua [9 fledglings, 11 adults], 20 Strix aluco [15 fledglings, 5 adults], and 20 Otus scops [6 fledglings and 14 adults]). Corneal touch threshold (CTT) was determined for each eye in five different corneal regions. Five attempts to cause a blink reflex were made in each region, and when three or more reflexes were positive, the pressure was deemed the CTT. Statistical analysis was performed using a Student's t-test for independent data or an anova model. The results between species and age groups were compared using the Generalized Estimated Equations model. RESULTS: There were no significant differences between any of the corneal regions (P = 0.25), or between the right (CTT = 4.9 ± 1.7 cm) and left (CTT = 4.8 ± 1.7 cm) eye in any of the species (P = 0.692). No difference was found between diurnal and nocturnal species (P = 0.913). Considering all the species, a significant difference was found between the mean CTT of fledglings (5.4 ± 1.2 cm) and adults (4.1 ± 2 cm), P < 0.001. A significant difference was found between fledglings and adults of A. noctua (P < 0.001) and S. aluco (P = 0.002). CONCLUSIONS: There is no significant difference in CTT between the different corneal regions in all the species studied. Corneal sensitivity is similar between diurnal and nocturnal birds of prey. Age is a determining factor in the CTT of A. noctua and S. aluco, with fledglings having a significantly higher CTT.