title: Superficial Keratectomy and Conjunctival Advancement Hood Flap (SKCAHF) for the Management of Bullous Keratopathy: Validation in Dogs With Spontaneous Disease.
abstract: OBJECTIVE
  To evaluate the efficacy of superficial keratectomy and conjunctival advancement hood flap (SKCAHF) for the treatment of bullous keratopathy in canine patients.
  
  
  METHODS
  Nine dogs (12 eyes) diagnosed with progressive corneal edema underwent superficial keratectomy followed by placement of conjunctival advancement hood flaps. The canine patients were examined pre- and postoperatively using in vivo confocal microscopy, ultrasonic pachymetry (USP), and Fourier-domain optical coherence tomography (FD-OCT). All owners responded to a survey regarding treatment outcomes.
  
  
  RESULTS
  Mean central corneal thickness (CCT) as measured by FD-OCT was 1163 ± 290 μm preoperatively and significantly decreased postoperatively to 795 ± 197 μm (P = 0.001), 869 ± 190 μm (P = 0.005), and 969 ± 162 μm (P = 0.033) at median postoperative evaluations occurring at 2.2, 6.8, and 12.3 months, respectively. Owners reported significant improvement (P < 0.05) in vision and corneal cloudiness at 6.8 and 12.3 months postoperatively. The percentage of cornea covered by the conjunctival flap was correlated (P = 0.0159) with a reduction in CCT by USP at 12.3 months postoperatively. All canine patients were comfortable pre- and postoperatively.
  
  
  CONCLUSIONS
  SKCAHF results in a reduction of corneal thickness in canine patients with bullous keratopathy. The increase in corneal thickness over time, after performing SKCAHF, is likely because of progressive endothelial decompensation. This surgery is a potentially effective intervention for progressive corneal edema in dogs that may have value in treatment of human patients with bullous keratopathy.
authors.affiliation: *Animal Eye Center, Rocklin, CA; †Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA; and ‡Department of Ophthalmology and Vision Science, School of Medicine, University of California-Davis, Davis, CA.
authors.forename: Taemi
authors.initials: T
authors.lastname: Horikawa
authors.forename: Sara M
authors.initials: SM
authors.lastname: Thomasy
authors.forename: Amelia A
authors.initials: AA
authors.lastname: Stanley
authors.forename: Allison S
authors.initials: AS
authors.lastname: Calderon
authors.forename: Jennifer
authors.initials: J
authors.lastname: Li
authors.forename: Lana L
authors.initials: LL
authors.lastname: Linton
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Murphy
mesh_terms: D000818:Animals; D001768:Blister / Q000000981:diagnostic imaging / Q000601:surgery / Q000662:veterinary*; D003228:Conjunctiva / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D003315:Cornea / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D015715:Corneal Edema / Q000000981:diagnostic imaging / Q000601:surgery / Q000662:veterinary*; D063171:Corneal Pachymetry / Q000662:veterinary; D004195:Disease Models, Animal; D004283:Dog Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D004285:Dogs; D005260:Female; D005583:Fourier Analysis; D008297:Male; D018613:Microscopy, Confocal / Q000662:veterinary; D013524:Surgical Flaps; D041623:Tomography, Optical Coherence / Q000662:veterinary