title: Penetrating sclerokeratoplasty and autologous pinnal cartilage and conjunctival grafting to treat a large limbal melanoma in a dog.
abstract: A four-year-old neutered male Labrador retriever presented to Portland Veterinary Specialists Ophthalmology Service for evaluation of a pigmented mass oculus sinister (OS) of approximately 4-month duration. Complete ophthalmic examination revealed a large, pigmented, raised, well-demarcated, epibulbar mass appearing to originate from the nasodorsal limbal region. The mass was smooth and roughly circular, extending approximately 4 mm into the sclera and 14 mm into the nasodorsal cornea. Gonioscopy directly under the mass was not possible due to mass size. The visible iridocorneal angle was normal. High-resolution B-scan ultrasound showed mass extension to Descemet's membrane and deep sclera, but no intraocular invasion. Penetrating sclerokeratoplasty was performed followed by autologous pinnal cartilage and conjunctival grafting to repair the corneoscleral defect (20 mm x 19 mm) and to restore globe integrity and function. Histopathology confirmed the mass to be a benign limbal melanoma with complete excision. The surgery site healed without complication, and the pinnal cartilage became fully incorporated into the globe. Twelve months postoperatively, the patient remains visual with a normal intraocular and fundic examination. The pinnal harvest site on the right ear healed without complication. To the authors' knowledge, this is the first reported case of corneoscleral grafting using autologous pinnal cartilage. This may represent a viable alternative to other corneoscleral grafting procedures for large defects and is an attractive treatment option due to lack of host rejection, readily available source of donor cartilage, and provision of tectonic support to the globe.
authors.affiliation: Portland Veterinary Specialists, Portland, ME.
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Mathes
authors.forename: Philip A
authors.initials: PA
authors.lastname: Moore
authors.forename: Angela E
authors.initials: AE
authors.lastname: Ellis
mesh_terms: D000818:Animals; D002356:Cartilage / Q000637:transplantation*; D003228:Conjunctiva / Q000601:surgery*; D004283:Dog Diseases / Q000601:surgery*; D004285:Dogs; D054644:Ear Auricle / Q000637:transplantation; D005134:Eye Neoplasms / Q000601:surgery / Q000662:veterinary*; D008297:Male; D008545:Melanoma / Q000601:surgery / Q000662:veterinary*; D013508:Ophthalmologic Surgical Procedures / Q000662:veterinary*
keywords: cartilage; corneal transplant; limbal melanoma; melanoma; penetrating sclerokeratoplasty; pinna