Outcome of surgical treatment of severe keratomalacia in dogs and cats with a 360‐degree conjunctival graft: 12 cases (2017‐2024)

OBJECTIVES: To retrospectively review the outcome of a 360-degree conjunctival graft in 12 dogs and cats with severe keratomalacia. MATERIALS AND METHODS: Ten dogs and two cats with keratomalacia involving more than 50% of the corneal surface were included. Four patients presented with concurrent corneal perforation, two with an associated iris prolapse. A 360-degree conjunctival graft and a temporary tarsorrhaphy were carried out in all patients and removed after a median time of 20 days. The final outcome was categorised into three groups (visual, blind, loss of the globe). The corneal transparency of visual eyes was further categorised according to a grading scheme into minimal (1), moderate (2) or severe (3) corneal opacity. RESULTS: Globe preservation was achieved in 10/12 (83.3%) of eyes, with 7/10 (70%) maintaining visual function. Corneal clarity scores among visual eyes were minimal in 57.1%, moderate in 28.6% and severe in 14.3%. Three out of four perforated eyes were successfully salvaged, with two retaining vision. Short-term complications included graft and/or tarsorrhaphy dehiscence (5/12), granulation tissue formation (3/12), panuveitis (1/12) and persistence of keratomalacia (2/12), resulting in enucleation of the latter two cases. Long-term complications of the remaining eyes included corneal fibrosis (9/10), pigmentation (8/10) and neovascularisation (6/10). CLINICAL SIGNIFICANCE: The 360-degree conjunctival graft is a useful and accessible treatment option for the management of severe keratomalacia in dogs and cats, offering high rates of globe preservation and visual function even in perforated eyes. Corneal opacity was minimal in the majority of cases at the last follow-up examination.