| Cornea ulceration is a common ophthalmic disease in veterinary clinics.The pathogen is mainly Staphylococcus Pseudintermedius.The current methods of treatment for corneal ulcers are drug therapy and drug therapy combined with surgical treatment,such as combined pedicled lamellar keratoplasty or pedicled conjunctival flap covering.However,there is no systematic study on the clinical efficacy for these two operations.In this study,we first conducted an epidemiological analysis of 102 cases of corneal ulcer in Zhengzhou,China area.Then,based on the epidemiological investigation,the main pathogenic bacteria were used to make canine corneal ulcer models,and then the pedicled lamellar keratoplasty and pedicled conjunctival flap were observed.The effect of covering surgery on corneal ulcers.The research report is as follows:Trial 1:Epidemiological investigation of 102 cases of canine corneal ulcer,isolation and identification of bacteria and analysis of drug resistance.Collect 102 cases of canine corneal ulcers admitted to three pet hospitals in Zhengzhou from June 2017 to December 2019,and count the causes,age,sex,breed,treatment methods and prognosis,etc.,and use sterile normal saline to moisturize Dip a cotton swab into a sample of the ulcer foci,culture and purify the collected sample,and then use the MALDI Biotyper system to identify the isolate.At the same time,the main strains isolated will be tested for the sensitivity of commonly used ophthalmology drugs.The test results are as follows:(1)The breeds with a higher incidence rate areTeedy,Bichon,Pekingese,Corgi,and mixed breed dogs;the age ranges from 2 months to 19 years old,with an average age of 5.8±0.54 years old.The main cause of the disease is trauma(22 cases,21.57%)and dry eye syndrome(14 cases,13.73%).(2)99 cases of positive bacterial culture,mainly mixed infections with Staphylococcus pseudintermediate infection;effective antibacterial drugs in vitro include Cefmenoxime(96.94%),Rifampicin(98.98%),Tobramycin It is resistant to tetracycline(91.84%),erythromycin(96.94%)and chloramphenicol(51.02%).Trial 2:Observation of the effect of different treatment methods on canine corneal ulcer caused by Staphylococcus pseudintermedius.Fifteen healthy adult beagle dogs were selected,3 dogs were randomly selected to antibiotic treatment group,and 12 dogs were used in the antibiotic combined surgical treatment group.Among them,the left eye underwent pedicle lamellar keratoplasty,and the right eye underwent pedicled conjunctival flap covering Surgery.A micro-syringe was used to draw Staphylococcus pseudintermediate bacteria liquid and inject it into the corneal stromal layer to construct a canine corneal ulcer model.48 h after modeling,the ulcer was washed with 0.5%povidone-iodine physiological saline solution.15 dogs were dripped with ofloxacin eye drops and sodium hyaluronate eye drops 12 times a day,with an interval of 1 min between the two drugs.The surgical treatment group undergoes surgical treatment after disinfection.Relevant clinical indicators and information were counted at 7,14,21,28,35 and 42 days postoperatively.Score based on clinical observation indicators and symptoms.The test results are as follows:(1)The experimental dogs in the antibiotic-only treatment group had corneal perforation,collapsed anterior chamber,prolapsed iris,shed tears,and increased ocular secretions within 36-46 hours after treatment;corneal edema,opacity,and neovascularization in multiple quadrants.The antibiotic treatment group was ineffective.(2)The score of corneal turbidity in the surgical treatment group:there was no statistical difference between the two groups before the operation(p>0.05);the score of the pedicled lamellar keratoplasty group at 7,14 and 21 days after surgery was significantly or extremely significantly higher than that of the band Pedicle conjunctival flap covering group(p<0.01 or p<0.05);28 days after operation,there was no statistical difference between the two groups;35 and 42 days after operation,the score of the pedicled lamellar keratoplasty group was significantly or extremely significantly lower than that of the pedicle Conjunctival flap covering group(p<0.01 or p<0.05).(3)Corneal neovascularization scores in the surgical treatment group:There was no statistical difference between the two groups before and 7 days after the operation(p>0.05);the scores in the pedicled lamellar keratoplasty group at 14,21,28 and 35 days after operation were significant or extremely significantly higher than the pedicled conjunctival flap covering group(p<0.01 or p<0.05);there was no statistical difference between the two groups after operation(p>0.05).(4)The score of corneal edema area in the surgical treatment group:there was no statistical difference between the two groups before the operation(p>0.05);the score of the pedicled lamellar keratoplasty group was significantly or extremely significantly higher than that of the pedicled conjunctiva at 7 and 14 days after surgery Valve covering group(p<0.01 or p<0.05);there was no statistical difference between the two groups at 21,28,35 and 42 days after operation(p>0.05).(5)The tear volume test results of the surgical treatment group:before and 2-6 days after the operation,there was no statistical difference between the two groups(p>0.05);8-18,32,38 and 42 days after the operation,with a pedicle the score of the lamellar keratoplasty group was significantly lower than that of the pedicled conjunctival flap covering group(p<0.01);at other time points,there was no statistical difference between the two groups(p>0.05).(6)The results of intraocular pressure detection in the surgical treatment group:before and 2-6 days after the operation,there was no statistical difference between the two groups(p>0.05);8-18,32,38 and 42 days after the operation,with the score of the pedicle lamellar keratoplasty group was significantly lower than that of the pedicled conjunctival flap covering group(p<0.01);at other time points,there was no statistical difference between the two groups(p>0.05).Trial 3:The effect of different treatment methods on the pathology of the canine corneal tissue and the expression of related cytokines with Staphylococcus pseudintermediate corneal ulcer.Twelve experimental dogs in the antibiotic combined surgical treatment group were randomly divided into four groups,and the corneas were surgically taken at 14,28,35,and 42 days after surgery.The collected cornea is divided into two along the surgical site,half is used for tissue section preparation,and the other half is used for fluorescence quantitative detection of cytokines.The test results are as follows:(1)Histopathological changes in the antibiotic-only treatment group:the corneal epithelial layer is missing,the structure is incomplete,some areas of the endothelial cell layer are missing,and the posterior elastic layer is missing.New granulation tissue can be seen in the ulcer,but the ulcer cannot be completely closed.(2)Histopathological changes in the surgical treatment group:the corneal structure in the pedicled lamellar keratoplasty group was complete,the corneal epithelial layer was re-epithelialized,the fibrin was arranged in an orderly manner,and the posterior elastic layer and endothelial layer were intact.The ulcer in the pedicled conjunctival flap covering group completely covered the conjunctival epithelium,the cell density was high,the arrangement was disorderly,new blood vessels were visible in the stromal layer,and the fibrin was arranged disorderly.The structure of the back-elastic layer and the endothelium is complete.(3)Changes in inflammatory factor-related gene expression:14 days and 28 days after surgery,compared with the pedicled conjunctival flap transplantation group,TLR2,IL-1?,IL-6,IL-8 in the pedicled lamellar keratoplasty group The relative expression of TNF-? and TNF-? mRNA increased significantly(p<0.01);35 days after the operation,compared with the pedicled conjunctival flap transplantation group,the TLR2 and TNF-? mRNAs in the pedicled lamellar keratoplasty group were relatively The expression level was extremely significantly increased(p<0.01),and the expression levels of other genes were not statistically different between the two groups(p>0.05);42 days after the operation,there was no statistical difference in the expression levels of each gene between the two groups(p>0.05)).(4)Changes in the expression of growth factor-related genes:14 days after the operation,compared with the pedicled conjunctival flap transplantation group,the relative expression of VEGF,FGF and TGF mRNA in the pedicled lamellar keratoplasty group increased significantly or extremely significantly.High(p<0.05 or p<0.01).At 28 days postoperatively,there was no statistically significant difference in the relative mRNA expression of each cytokine between the two groups(p>0.05).At 35 and 42 days postoperatively,compared with the pedicled conjunctival flap transplantation group,the relative expression of TGF mRNA in the pedicled lamellar keratoplasty group was significantly reduced(p<0.05),while the relative expression of other cytokines was not Statistical difference(p>0.05).Trial 4:Observation of the effect of pedicled lamellar keratoplasty on clinical cases of canine deep corneal ulcer.Clinical cases of canine deep corneal ulcer were taken after pedicled lamellar keratoplasty,and the observation was continued for 60 days.The postoperative tear volume fluctuated up and down within the normal range,the intraocular pressure was lower than the normal range within 5-11 days after the operation,and the rest time points were within the normal range.There were no cases of reinfection,two boxes of postoperative recovery effect,and vision were restored.In summary,the dog breeds in the 102 cases of canine corneal ulceration in Zhengzhou city were mostly Teddy and Brachycephalic dogs.The infected bacteria are mainly Staphylococcus pseudointermediate and are resistant to erythromycin,chloramphenicol and tetracyclines.The postoperative recovery effect of lamellar keratoplasty is better than that of conjunctival flap covering,the cornea is healed and transparent,the fibrin is arranged in an orderly manner,and the epithelial structure is complete. |
PDF Full Text Request