Long‐term outcome of autologous fascia lata grafting with conjunctival flap overlay in horses with ulcerative keratitis and keratomalacia

Abstract

AbstractObjectivesTo describe the technique, postoperative complications, and outcome after autologous fascia lata grafting with conjunctival flap overlay in horses with ulcerative keratitis and keratomalacia.Study designRetrospective case series.AnimalsEleven horses with ulcerative keratitis and keratomalacia.MethodsHorses included had undergone fascia lata grafting with conjunctival flap overlay due to impending or recent corneal perforation. Preceding therapy, lesion characteristics, postoperative complications, and short‐ and long‐term outcomes were recorded.ResultsPostoperative complications included complete (1/11) or partial (2/11) dehiscence of the conjunctival flap and fascia lata graft, postoperative pneumonia (1/11), intermittent hypercreatinemia (2/11) and mild uveitis after trimming of the conjunctival flap (9/10). The donor sites healed without complications (11/11). A satisfactory short‐term outcome (at cessation of medical therapy) was achieved in all horses (11/11).Long‐term follow‐up (median 29 months, range 7–127 months) was available for 10/11 horses. A comfortable eye with functional vision was achieved in 9/10 horses with long‐term follow‐up, including 3/4 horses with prior corneal perforation and 1/11 horses in which the fascia lata graft completely dehisced 15 days after surgery. Enucleation was required in a single horse (1/10) after phthisis bulbi developed 7 months postoperatively.ConclusionFascia lata grafting with conjunctival flap overlay appears to be a viable solution for globe preservation in horses with ulcerative keratitis and keratomalacia. Long‐term ocular comfort with functional visual outcomes can be achieved in most cases with limited concerns for donor site morbidity while bypassing acquisition, storage or lesion‐size limitations related to other biomaterials.