Deep anterior lamellar keratoplasty (DALK) as a treatment of a deep stromal ulcer in a dog: case report

Abstract

Characterized by the rupture of the corneal epithelium, corneal ulcers threaten ocular integrity, with multifactorial development, such as decreased protection and excessive abrasion applied to the corneal surface. Keratoplasty restores the corneal anatomy, removing the inflamed or infected tissues, in order to promote visual acuity. The technique of deep anterior lamellar keratoplasty (DALK) selectively removes the diseased layers of the cornea, keeping the Descemet membrane and endothelium healthy, reducing the risk of rejection, aimed at tissue recovery. In the present report, a canine, from the Shih Tzu breed, a female, that has not been castrated, 2 years and 6 months old, was treated, she had a history of ocular discomfort and mucous secretion in both eyes. In the ophthalmic examination, keratoconjunctivitis sicca was found in the left eye and ectopic cilia was found in both eyes. With the aid of a fluorescein test, the presence of a deep stromal ulcer affecting the right eye was confirmed. The patient underwent ectopic cilia removal using the wedge resection technique and an allogeneic corneal transplantation using DALK, with only the diseased epithelium and stroma being replaced, reducing the risk of rejection and failures related to surgery. 90 days after the procedure, there was no reaction to the graft, there was complete epithelial repair and maintenance of visual function with slight corneal opacity.