豚膀胱由来無細胞マトリックスによる犬と猫の角膜再建

OBJECTIVE:To describe the use of a porcine urinary bladder acellular matrix for surgical reconstruction of the cornea in cases of canine and feline deep corneal ulcers, and feline corneal sequestra. MATERIALS AND METHODS: Twenty-seven dogs and three cats with deep corneal ulcers and seven cats with corneal sequestra were included in the study with overall 38 eyes. For each patient, the necrotic material (ie corneal sequestrum or collagenolytic tissue) was removed by circular lamellar keratectomy. The collagen graft was then cut and prepared to match the stromal defect and then sutured into the lamellar keratectomy bed using interrupted and continuous patterns of absorbable polyglactin 9-0 sutures. Postoperative medical treatment consisted of topical and systemic administration of antibiotics, combined with topical administration of atropine sulfate. The animals were examined 18, 45, and 90 days after the surgery. RESULTS: Postoperative examination revealed complete integration of the biomaterial in 93.5% of ulceration cases in both species and in 100% of feline corneal sequestrum cases. In two cases of ulceration (1 dog and 1 cat), progression of the collagenolytic process at the graft periphery required an additional conjunctival graft 7 days after the first surgery. At 90 days post-op, 100% of the eyes were sighted. CONCLUSIONS: Use of a porcine urinary bladder acellular matrix appears to be effective in the surgical management of deep corneal ulcers and feline corneal sequestra.