Corneal collagen cross-linking (CXL) for the treatment of melting keratitis in cats and dogs: a pilot study

Authors

  • Bernhard M. Spiess,

    1. Equine Department, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, CH-8057 Zurich, Switzerland
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  • Simon A. Pot,

    1. Equine Department, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, CH-8057 Zurich, Switzerland
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  • Marion Florin,

    1. Equine Department, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, CH-8057 Zurich, Switzerland
    Current affiliation:
    1. Augen Vet, Animal Eye Service, Vienna, Austria
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  • Farhad Hafezi

    Corresponding author
    1. Division of Ophthalmology, Department of Clinical Neurosciences, University Hospitals of Geneva, Rue Alcide-Jentzer 22, CH-1211 Geneva 14, Switzerland
    • Address communications to:

      F. Hafezi

      Tel.: +41 22 382 83 60

      Fax: +41 22 382 84 33

      e-mail: farhad.hafezi@hcuge.ch

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  • B.S. and S.P. have contributed equally to this study.

Abstract

Objective

UV-A/riboflavin cross-linking (CXL) of corneal collagen fibers is an established, highly promising therapy for corneal melting in physician-based ophthalmology. A prospective pilot study was conducted to demonstrate proof of principle of this novel method for the treatment of melting corneal ulcers in dogs and cats.

Procedures

After obtaining owner consent, CXL was performed in three cats and three dogs with corneal melting, which either affected the entire corneal surface or was resistant to conventional antibiotic and anticollagenolytic therapy, and affected parts or all of the corneal surface. Medical therapy was continued in all patients. The available follow-up ranged from 2 to 22.5 months and involved slit-lamp examination, fluorescein staining, and photographic documentation during all rechecks.

Results

Surgical stabilization of the cornea was not necessary in any case, because progression of corneal melting was arrested in all cases within 1–20 days of CXL treatment. Corneal re-epithelization occurred within 7–40 days in all eyes. At 40 days after CXL, all eyes presented a quiescent corneal state without signs of active inflammation and with beginning scar formation. The complications observed in three of the six animals included a corneal sequestrum, superficial corneal stromal pigmentation, and bullous keratopathy.

Conclusions

This study shows the feasibility of CXL to treat progressive corneal melting in veterinary patients. CXL may represent a cost-efficient and safe alternative therapy in the treatment for corneal melting in veterinary ophthalmology. More investigations comparing the effectivity and complication rate of CXL to those of standard medical treatment are necessary.

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