Journal of Veterinary Clinics (한국임상수의학회지)

The Korean Society of Veterinary Clinics (한국임상수의학회)
권호 표지

Equine Amniotic Membrane Transplantation in Corneal Perforation Resulting from Melting Ulcer in a Dog

녹는 궤양에 기인한 각막 천공에서 각막 재건을 위한 말양막이식술 증례

  • Kim, Jury (College of Veterinary Medicine, Chonbuk National University) ;
  • Bae, Jaehyun (College of Veterinary Medicine, Chonbuk National University) ;
  • Kwon, Yong-Hwan (College of Veterinary Medicine, Chonbuk National University) ;
  • Kim, Nam-Soo (College of Veterinary Medicine, Chonbuk National University) ;
  • Kim, Min-Su (College of Veterinary Medicine, Chonbuk National University)
  • Accepted : 2013.02.13
  • Published : 2013.02.28
Download PDF
⟨ Previous Next ⟩

Abstract

A 4-year-old castrated male Shih-Tzu was presented to the Chonbuk National University Animal Medical Center with a history of melting ulcer in the right eye (OD). Upon ophthalmologic examination, severe keratomalacia of approximately 70% of the entire surface area with a full thickness corneal defect was found in OD. In addition, iris and fibrin clots were observed on the center of the corneal defect. The menace response and dazzle reflex were normal in OS. As the size and damage of corneal perforation was so severe, amniotic membrane (AM) transplantation was considered to repair the cornea instead of direct suture technique, flap methods or corneal transplantation. Equine AM was sutured to the limbus to cover the entire cornea in a single interrupted pattern using 9-0 nylon suture material. On day 79, mild scarring and pigmentation, with almost no vasculature, remained. The menace response and dazzle reflex were normal of OD. Although pigmentation and scarring remained on the cornea, equine AM transplantation can be useful for reconstruction of severe corneal perforation with keratomalacia.

4년령 중성화한 수컷 시츄견이 우안에 녹는 궤양이라는 기왕력으로 전북동물의료센터에 내원했다. 안과 검사결과 우안에 각막 전체의 70%에 해당하는 각막 연화를 동반한 각막 천공이 관찰되었다. 또한 홍채 탈출과 섬유소 응괴가 각막 천공 중앙부에서 관찰되었다. 좌안의 위협 반사와 대광 반사는 정상이었다. 각막 결손 부위가 너무 컸기 때문에 각결막 판을 이용한 방법이나 각막 직접 봉합을 배제하였으며 말양막이식술을 시행하기로 결정했다. 말양막은 각막 윤부에 전체 각막을 다 덮을 수 있도록 9-0 나일론 봉합사를 이용하여 봉합을 실시했다. 양막이식 후 79일 째 육아조직과 색소침착이 다소 남아있었으나 우안의 위협 반사와 눈부심 반사는 모두 정상이었다. 비록 색소 침착과 육아조직이 각막에 남아있기는 했지만 개에서 말양막이식술은 녹는 궤양으로 기인한 각막 천공에서 시행해 볼 수 있는 유용한 치료법으로 생각된다.

Keywords

References

  1. Barachetti L, Giudice C, Mortellaro CM. Amniotic membrane transplantation for the treatment of feline corneal sequestrum: pilot study. Vet Ophthalmol 2010; 13: 326-330. https://doi.org/10.1111/j.1463-5224.2010.00821.x
  2. Barros PS, Garcia JA, Laus JL, Ferreira AL, Salles Gomes TL. The use of xenologous amniotic membrane to repair canine corneal perforation created by penetrating keratectomy. Vet Ophthalmol 1998; 1: 119-123. https://doi.org/10.1046/j.1463-5224.1998.00026.x
  3. Barros PS, Safatle AM, Godoy CA, Souza MS, Barros LF, Brooks DE. Amniotic membrane transplantation for the reconstruction of the ocular surface in three cases. Vet Ophthalmol 2005; 8: 189-192. https://doi.org/10.1111/j.1463-5224.2005.00391.x
  4. Choi US, Labelle P, Kim S, Kim J, Cha J, Lee KC, Lee HB, Kim NS, Kim MS. Successful treatment of an unusually large corneal epithelial inclusion cyst using equine amniotic membrane in a dog. Vet Ophthalmol 2010; 13: 122-125. https://doi.org/10.1111/j.1463-5224.2010.00765.x
  5. Gilger BC, with contributions by Olliver FJ, Bentley E. Diseases and surgery of the canine cornea and sclera. In: Veterinary ophthalmology, 4th ed. Oxford Blackwell Publishing Ltd., 2007: 690-752.
  6. Kalpravidh M, Tuntivanich P, Vongsakul S, Sirivaidyapong S. Canine amniotic membrane transplantation for corneal reconstruction after the excision of dermoids in dogs. Vet Res Commun 2009; 33: 1003-1012. https://doi.org/10.1007/s11259-009-9319-z
  7. Kim JY, Choi YM, Jeong SW, Williams DL. Effect of bovine freeze-dried amniotic membrane (Amnisite-BA) on uncomplicated canine corneal erosion. Vet Ophthalmol 2009; 12: 36-42. https://doi.org/10.1111/j.1463-5224.2009.00671.x
  8. Lassaline ME, Brooks DE, Ollivier FJ, Komaromy AM, Kallberg ME, Gelatt KN. Equine amniotic membrane transplantation for corneal ulceration and keratomalacia in three horses. Vet Ophthalmol 2005; 8: 311-317. https://doi.org/10.1111/j.1463-5224.2005.00405.x
  9. Lewin GA. Repair of a full thickness corneoscleral defect in a German shepherd dog using porcine small intestinal submucosa. J Small Anim Pract 1999; 40: 340-342. https://doi.org/10.1111/j.1748-5827.1999.tb03094.x
  10. Maggs DJ. Cornea and sclera. In: Slatter's fundamentals of Veterinary Ophthalmology, 4th ed, St. Louis: Saunders Elesvier, 2008: 190-191.
  11. Plummer CE. The use of amniotic membrane transplantation for ocular surface reconstruction: a review and series of 58 equine clinical cases (2002-2008). Vet Ophthalmol 2009; 12 Suppl 1: 17-24.
  12. Sanchez RF, Innocent G, Mould J, Billson FM. Canine keratoconjunctivitis sicca: disease trends in a review of 229 cases. J Small Anim Pract 2007; 48: 211-217. https://doi.org/10.1111/j.1748-5827.2006.00185.x
  13. Sangwan VS, Burman S, Tejwani S, Mahesh SP, Murthy R. Amniotic membrane transplantation: a review of current indications in the management of ophthalmic disorders. Indian J Ophthalmol 2007; 55: 251-260. https://doi.org/10.4103/0301-4738.33036
  14. Vongsakul S, Tuntivanich P, Sirivaidyapong S, Kalpravidh M. Canine amniotic membrane transplantation for ocular surface reconstruction of created deep corneal ulcers in dogs. Thai J Vet Med 2009; 39: 135-144.
  15. Wilkie DA, Whittaker C. Surgery of the cornea. Vet Clin North Am Small Anim Pract 1997; 27: 1067-1107. https://doi.org/10.1016/S0195-5616(97)50104-5