Long-term outcome of autologous fascia lata grafting with conjunctival flap overlay in horses with ulcerative keratitis and keratomalacia.
Authors: Hoerdemann Mona, Yarbrough Thomas
Journal: Veterinary surgery : VS
Summary
# Autologous Fascia Lata Grafting for Severe Equine Corneal Disease When horses develop deep corneal ulceration or keratomalacia with impending perforation, surgical intervention becomes critical for globe preservation. Hoerdemann and Yarbrough retrospectively analysed 11 horses that underwent autologous fascia lata grafting overlaid with a conjunctival flap—a surgical approach that harvests tissue from the horse's own thigh fascia to reinforce the compromised cornea. All horses achieved satisfactory short-term outcomes, and long-term follow-up (median 29 months) demonstrated that 9 out of 10 cases resulted in a comfortable, functional eye, even amongst the three animals with prior corneal perforation and remarkably, the one horse whose graft completely separated just 15 days post-surgery. Postoperative complications were generally manageable, including transient mild uveitis in most cases and isolated instances of graft dehiscence or systemic complications, whilst all donor sites healed without problem. This technique offers farriers and veterinarians a practical, autologous alternative for corneal reconstruction that circumvents the logistical constraints and size limitations of other biomaterials, though careful monitoring for uveitis during the healing phase and conjunctival flap trimming remains essential to achieving optimal visual outcomes.
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Practical Takeaways
- •Fascia lata grafting is a practical surgical option for corneal emergencies in horses, with high success rates for preserving vision and comfort without requiring expensive biomaterials or storage logistics
- •Even if the graft partially or completely dehisces postoperatively, many horses still achieve functional vision long-term, so early dehiscence should not prompt immediate enucleation
- •Mild uveitis is common after conjunctival flap trimming but appears manageable; plan for monitoring and medical therapy during the healing phase
Key Findings
- •Fascia lata grafting with conjunctival flap overlay achieved satisfactory short-term outcomes in all 11 horses (11/11)
- •Long-term follow-up (median 29 months) showed 9/10 horses achieved a comfortable eye with functional vision
- •Complete or partial dehiscence occurred in 3/11 cases, but 1 horse with complete dehiscence still achieved functional vision
- •Donor site healing was complication-free in all cases (11/11), with no long-term morbidity reported