Surgery of corneal ulcers

Corneal ulcers are commonly found in cats suffering with feline herpesvirus infection with medical therapy is often indicated.  Because of the delicate anatomy of the cornea and the complexity of the surgery, the decision between medical and surgical treatment needs to be evaluated carefully. A recent review suggests that surgery should be considered in 4 main situations:

• When more than 2/3 of corneal depth has been lost
• When the ulcer is progressing rapidly
• If medical treatment has failed
• If healing is likely to be compromised (for instance, because of poor tear production or corneal exposure)

Agenesia, entropion, ectopic cilia and the inability to, stromal abscesses, foreign bodies, neoplasia and sequestra are examples of cases where surgery may be the better option. Emergency cases, including cats with corneal foreign bodies, corneal perforations and descemetoceles, also need to be resolved rapidly to avoid further complications, making surgery the first choice.

If you are attempting corneal surgery, remember that there is a risk of corneal perforation and be prepared. The right equipment and experience in intraocular surgery are essential.

In Treatment of Corneal Ulcers: When is Surgery Indicated?    Claudia Hartley, Journal of Feline Medicine and Surgery 2010