Feline Corneal Sequestra

In the Literature

Graham KL, White JD, Billsom FM. Feline corneal sequestra: outcome of corneoconjunctival transposition in 97 cats (109 eyes). J Feline Med Surg. 2017;19(6):710-716.

The Research …

Corneal sequestra are discolored areas on the cornea, with or without epithelial loss, and are caused by necrosis and breakdown of focal area stromal collagen.¹ Predisposing and underlying factors include breed (eg, brachycephalics), viral disease (eg, FHV-1), and structural abnormalities (eg, entropion).

Correction of underlying cause is an important step, along with treatment of the sequestrum itself, although underlying cause may not always be known. Knowledge of options for treatment, monitoring, and/or referral is vital.

Medical therapy and/or keratectomy alone may be curative for superficial lesions. However, lesion depth may necessitate an additional grafting procedure (eg, corneoconjunctival transposition, conjunctival flap, porcine small intestinal submucosal graft, corneal transplant).^2,3 

In this study of 97 cats (109 eyes), a relatively good outcome was obtained with corneoconjunctival transposition, with a relatively low reported recurrence rate (8.3%). However, 28 cats (28.9%) developed a sequestrum in the contralateral eye during the follow-up period.

… To Your Patients

Key pearls to put into practice:

• Clinicians should carefully select patients for referral and/or surgical therapy by performing a thorough ophthalmic examination and recording and correcting any possible underlying causes for corneal sequestration.

• Prophylactic topical antibiotics and oral pain medications should be used in surgical and nonsurgical cases.

• Clinicians should tell owners that surgical procedures discussed in this paper may be indicated in some cases (particularly for painful patients), that recurrence or a new lesion in the contralateral eye is possible, and that intensive follow-up may be required.