| Inert corneal ulcer,also known as chronic corneal epithelial erosion,is a type of chronic corneal epithelial ulcer that does not heal through normal wound healing processes.Inert corneal ulcer often occurs in middle-aged and older canines,which it is common diseases and difficult to treat in the cornea.Conjunctival flap surgery is usually considered in situations when eye drops,corneal debridement,tracheotomy,and carotenoid epithelium removal are ineffective.This article proposes an improved conjunctival flap surgery,w hich used traditional conjunctival flap surgery as a control,to research the effect of modified edge conjunctival flap opacification on the treatment of canine inert corneal ulcer.The subjects were 12 canines with canine inert corneal ulcers from the clinic and were divided into two groups.Group A was a conventional conjunctival flap-covering group,and group B was a modified edge conjunctival flap-covering surgery,each group with 6 cases.At the same time,local eye-drop treatment of serum and corneal epithelial growth factor was performed on the 7th,14 th and 30 th days respectively.Through the clinical scores of the canine's corneal opacity,neovascularization,and sodium fluorescein staining,a comprehensive evaluation of the clinical efficacy of modified edge conjunctiva flap surgery for the treatment of indolent corneal ulcer was performed the results are as follows:(1)The corneal turbidity scores of the two surgical methods: on the 7th day,the corneal turbidity score in group A was 3.16±0.41 points,and the corneal turbidity score in group B was 2.83±0.41 points.The scores showed that the turbidity was generally higher,but the corneal turbidity of group A was higher than that of group B.There was no significant difference between the two groups.on the 14 th day,the corneal turbidi ty score in group A was 2.67±0.59,and the corneal haze score in group B was 1.55±0.58.The scores showed that corneal turbidity in group A decreased compared with the 7th day,and corneal turbidity in group B decreased compared with the 7th day.There was a significant difference between the two groups(P<0.05).on the 30 th day,the corneal turbidity score in group A was 0.83 ±0.41,and the corneal haze score in group B was 0.The results showed that corneal turbidity in group A was significantly lower than that on the 14 th day,but there were still scars,cornea was not transparent enough,and the cornea in group B was almost completely transparent.There was a significant difference between the two groups(P<0.05).(2)In the appearance of corneal neovascularization: on the 7th day,the corneal neovascularization score in group A was 1.16 ± 0.41 points,and the corneal neovascularization score in group B was 2.16 ± 0.75 points.The results showed that neovascularization began in both corneas,which was significantly higher in group B than in group A(P<0.05).on the 14 th day,the corneal neovascularization score in group A was 1.83±0.41.Scores of corneal neovascularization in group B and group B were 2.83±0.41.The results showed that the neovascularization in group B increased,and neovascularization in group A was also higher than that in group B,but less than group B.There was a significant difference between group B and group A(P<0.05).on the 30 th day,A The corneal neovascularization score in the group was 0.16 ± 0.41 points,and the corneal neovascularization score in group B was 0 point.The results showed that in group B,the cornea was almost completely transparent and there was almost no neovascularization.Compared with group B,the number of new blood vessels in group A was significantly reduced but there was still a small number of neovascularization.There was no significant difference compared with group B.(3)In corneal fluorescein sodium staining score results,the corneal damage situation: on the 7th day,the score in group A was 2±0 points,and the score in group B was 1.33±0.52 points.The results of the scoring showed that the corneas of both groups had coloration,but the coloring points of group B were less than that of group A.The difference between group A and group B was significant(P<0.05).on the 14 th day,the score of group A was 1.33 ±0.52 points.The score in group B was 0.67±0.52 points.The score results showed that the corneal stained spots in group A and B were decreased compared with the 7th day,but the staining spots in group B were less than in group A,and the difference between group A and group B was significant(P<0.05);on the 30 th day,the score in group A was 0.16±0.41,and the score in group B was 0.The scoring results showed that the corneal stained spots in group A and group B were significantly reduced compared with the 14 th day,and there was no significant difference between group A and group B.(4)In terms of treatment efficiency: 5 cases of corneal ulcer heal ed by traditional conjunctival flap surgery were treated with an effective rate of 83.3%;6 cases of corneal ulcer healed with modified edge conjunctival flap were treated with an effective rate of 100%.(5)Total treatment time of the two operations: In the 6 cases with conventional conjunctival flap closure,the longest corneal healing cycle was 5 weeks(1 canine),the shortest corneal healing cycle was 4 weeks(5 canines).The average healing time was 4.16±0.41 weeks.In the 6 cases with modified edge conj unctival flap,all the 6 canines had a healing time of 4 weeks.The average healing time is 4 weeks.This shows that the improved edge conjunctival flap and traditional conjunctival flap in the treatment of superficial inertial corneal ulcer,although the modified conjunctival flap healing time is slightly shorter than the traditional conjunctival flap,but the difference was not significant(p> 0.05).Conclusion: Modified conjunctival flap edge conjunctival flap survival rate is higher than conventional surgery conjunctival flap;The degree of neovascularization after modified conjunctival flap closure was higher than that of traditional conjunctival flap covering,which reduced the irregular arrangement of collagen fibers,thereby reducing the formation of scars and improving the transparency of the cornea.Both surgical methods can promote the healing of the corneal ulcer,and the ulcer healing time is basically same,but the modified edge conjunctival flap clot healing time is slightly shorter. |
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