Surgical treatment of canine and feline descemetoceles, deep and perforated corneal ulcers with autologous buccal mucous membrane grafts

Objectives: To report the surgical technique and postoperative outcome of corneal repair with autologous buccal mucous membrane grafts in dogs and cats with descemetoceles, deep corneal ulcers, and perforated corneal ulcers with or without iris prolapse. Animal studied: Twelve cats (13 eyes) and fourteen dogs (14 eyes) were treated. Procedures: Grafts were harvested from the unpigmented superior labial mucosa using a biopsy punch. The corneal lesion was carefully debrided and cleaned. The graft was secured to the healthy cornea with a combination of simple interrupted and continuous 9–0 polyglycolic acid sutures. In 25/27 treated eyes, an overlying pedicle conjunctival graft was also performed. A temporary nictitating membrane flap was used in all cases. The pedicle conjunctival graft was trimmed about 10–20 days postoperatively. The median follow-up period was 549.2 days (range 14–2691 days). Results: No surgical intra-operative complications were observed. The ulcers healed and the integrity of the globe was restored in 24/27 treated eyes. Different grades of corneal fibrosis and/or vascularization and/or pigmentation were observed in all cases at the long-term follow-up. In two cases, enucleation was performed due to postoperative complications and one animal developed phthisis bulbi. A total of 22/27 treated eyes appeared to have regained effective visual function at the last clinical evaluation. Conclusions: Autologous buccal mucous membrane grafts appear to successfully manage severe corneal ulcers in dogs and cats, providing a useful and economical alternative to other corneal grafts.