Bir kedide bilateral ankiloblefaronun eşlik ettiği simblefaronun cerrahi yönetimi

Öz

Kedilerde sıkça görülen felin herpesvirus enfeksiyonları, göz ve çevresindeki dokularda meydana gelen şiddetli yangısal reaksiyonlar sonrasında, kronik konjunktival yapışıklıklara yol açarak, etkilenen hayvanlarda görme kaybına neden olur. Bu yapışıklıklar anatomik türlerine göre simblefaron veya ankiloblefaron olarak sınıflandırılır. Bu olgu sunumu, bir yavru kedide birlikte görülen simblefaron ve ankiloblefaronun klinik değerlendirmesini ve tedavi yaklaşımını tanımlamaktadır. Çalışmada, her iki göz kapağında deformasyonlar ve kornea üzerinde yaygın konjunktival yapışıklıklar ile getirilen 3 aylık erkek yavru kedi, şiddetli simblefaron ve ankiloblefaron tanısı aldı. Ardından cerrahi müdahale yapılarak yapışıklıklar dikkatlice ayrıldı. Cerrahi sırasında konjunktivanın kornea ve limbus bölgesine yapışmadığı gözlemlendi. Tek bir postoperatif nüks yaşayan hayvanda, adezyonlar sadece palpebral konjunktivada gözlemlendi ve bunlar daha sonra uzaklaştırılarak medikal sağaltım ile desteklendi. Yaklaşık 5 ay takip edilen kedide nüks gözlenmedi.

Anahtar Kelimeler

• Adezyon
• Felin Herpesvirus Tip-1
• Konjunktivalizasyon
• Limbal yetmezlik

Surgical management of bilateral symblepharon accompanied by ankyloblepharon in a cat

Öz

Feline herpesvirus infections, frequently observed in cats, lead to chronic conjunctival adhesions resulting in vision impairment in affected animals, following intense inflammatory responses occurring in the eye and periocular tissues. These adhesions are classified as symblepharon or ankyloblepharon according to the anatomical types. This case report describes the clinical evaluation of symblepharon and ankyloblepharon seen together in a kitten, along with the treatment approach. In the study, a 3-month-old male kitten, presented with bilateral eyelid deformations and extensive conjunctival adhesions on the cornea, was diagnosed with severe symblepharon and ankyloblepharon. Subsequently, surgical intervention was performed and the adhesions were carefully separated. During the surgery, it was observed that the conjunctiva did not adhere to the cornea and limbus area. In the animal that experienced a sole postoperative recurrence, growth and adhesion were observed exclusively in the palpebral conjunctivae, which were subsequently removed and supported with medical treatment. No recurrence was observed in the cat, which was followed for approximately 5 months.

Anahtar Kelimeler

• Adhesion
• Conjunctivalization
• Feline Herpesvirus Type-1 (FHV-1)
• Limbal deficiency

Kaynakça

1. Li T, Shao Y, Lin Q, Zhang D. Reversed skin graft combining with lip mucosa transplantation in treating recurrent severe symblepharon: A case report. Medicine (Baltimore). 2018;97(35):1-4.
2. Kim Y, Kang S, Seo K. Application of superficial keratectomy and soft contact lens for the treatment of symblepharon in a cat: a case report. J Vet Sci. 2021;22(2):1-5.
3. Hendrix DV. Diseases and surgery of the canine conjunctiva and nictitating membrane. In: Gelatt KN, Gilger BC, Kern TJ, eds. Veterinary Ophthalmology. Baltimore: Lippincott Williams and Wilkins; 2012:945-975.
4. Senel OO, Ergin I. Medical and surgical treatment of severe corneal alkaline burn in a cat. Vet Hek Der Derg. 2014;85(1):24-28.
5. Williams DL, Flach E. Symblepharon with aberrant protrusion of the nictitating membrane in the snowy owl (Nyctea scandiaca). Vet Ophthalmol. 2003;6(1):11-13.
6. Gelatt K. Veterinary Ophthalmology. 4th ed. Blackwell Publishing; 2007.
7. Kumar P, Punnoose SE, Jain V. Grade I ankyloblepharon following chemical burn. Plast Reconstr Surg. 2005;116(4):1175-1176.
8. Spiess BM. Conjunctiva and third eyelid. In: Martin CL, Pickett JP, Spiess BM, eds. Ophthalmic Disease in Veterinary Medicine. Boca Raton: CRC press Taylor, Francis; 2019:235-280.

9. Shiraishi H, Vernau KM, Kim S, Good KL, Hollingsworth SR, Sebbag L, Maggs DJ. Symblepharon in kittens: a retrospective study of 40 kittens and 54 eyes (2002–2022). J Feline Med Surgery. 2023;25(2):1-13.
10. Ledbetter EC, Badanes ZI, Chan RX, Donohue LK, Hayot NL, Harman RM, Van de Walle GR, Mohammed HO. Comparative Efficacy of Topical Ophthalmic Ganciclovir and Oral Famciclovir in Cats with Experimental Ocular Feline Herpesvirus-1 Epithelial Infection. J Ocul Pharmacol Ther. 2022;38(5):339-347.
11. Gould D. Feline Herpesvirus-1: Ocular Manifestations, Diagnosis and Treatment Options. J Feline Med Surg. 2011;13:333-346.
12. Sainkaplan S, Irdem DI, Ergin I. Assessment of Ocular Lesions in a Persian Cat Concurrently Infected with Chlamydia felis, Herpesvirus and Coronavirus. Kafkas Univ Vet Fak Derg. 2022;28(6):781-784.
13. Maggs DJ. Diseases of the conjunctiva. In: Maggs DJ, Miller P, Ofri R, eds. Slatter's Fundamentals of Veterinary Ophthalmology. St. Louis: Elsevier Health Sciences; 2018:158-177.
14. Gallhoefer NS, Bentley E, Ruetten M. Comparison of ultrasonography and histologic examination for identification of ocular diseases of animals: 113 cases (2000–2010). J Am Vet Med Assoc. 2013;243(3):376-387.
15. Glaze MB, Gelatt K. Feline ophthalmology. In: Gelatt KN, ed. Veterinary Ophthalmology. Baltimore: Lippincott Williams and Wilkins; 1999:1024-1124.