Treatment of bullous keratopathy with corneal collagen cross-linking in two dogs

Simon A Pot, Nicolin S Gallhöfer, Ladina Walser-Reinhardt, Farhad Hafezi, Bernhard M Spiess
Objective Corneal collagen cross-linking with riboflavin and UV-A (CXL) decreases corneal oedema and increases visual acuity in human patients with bullous keratopathy. Presumed mechanisms are an increase in collagen packing density and a reduction in stromal swelling pressure. We present two cases in which CXL was used to treat bullous keratopathy in dogs. Procedures Four eyes of two dogs with painful bullous keratopathy-induced corneal erosions that were resistant to prior therapy were
more » ... therapy were treated with CXL. Both corneas of the second patient were dehydrated to AE 400 lm corneal thickness using topical 70% glycerol solution immediately prior to CXL. Follow-up included slit-lamp examination, fluorescein staining and photographic documentation in both cases and highresolution ultrasound examination in the second patient. Results All four eyes were comfortable and fluorescein negative at 1-week post-CXL and remained so for the rest of the follow-up period (17.5 months for case 1 and 6 months for case 2). The owner of the first patient reported a less oedematous cornea and improvement in vision that lasted for 6 months. Despite a reported lack of improvement in vision in the second patient, corneal thickness initially decreased, but was back at baseline thickness at the 4-month recheck. Conclusions Similar to humans, CXL might become a useful treatment option for bullous keratopathy-induced therapy-resistant corneal erosions in dogs. Patient comfort was greatly improved, but corneal thickness decrease was not as long-lasting as reported for humans. The presently used protocols might need modification to fit the dog cornea.
doi:10.5167/uzh-119095 fatcat:uqadympl4rdifd34b6sfeqvw24