Treatment
When selecting the best treatment approach, factors such as lesion depth, corneal integrity, and the animal’s comfort level are carefully evaluated. Medical management may be attempted in mild or early cases. This typically includes:
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Topical lubricants to support the tear film and protect the corneal surface
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Broad-spectrum topical or systemic antibiotics to manage or prevent secondary bacterial infection
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Antiviral medications, where feline herpesvirus is suspected
However, due to the typically painful nature of the condition and its association with ulceration, surgical excision of the sequestrum is often the treatment of choice. Surgery not only relieves discomfort but also helps to prevent further corneal degradation and supports long-term healing.
Surgical technique
The lesion is typically excised under high magnification using lamellar corneal knives. These allow for controlled removal by slicing thin layers of necrotic tissue, gradually working down to healthy corneal stroma. In cases where the remaining cornea is too thin, or the sequestrum is full-thickness, it is often necessary to prepare a graft early in the procedure. Grafting options may include:
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Conjunctival grafts (such as pedicle or hood grafts), which provide vascular support and promote healing
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Corneal grafts, offering structural integrity and clearer optical outcomes, especially when the lesion involves the visual axis
These cases can be technically demanding, requiring both surgical skill and postoperative diligence. Success depends on timely intervention, appropriate case selection, and ongoing monitoring.
Despite correct surgical management, recurrence is possible. Therefore, clear and thorough communication with pet owners is essential. Clients should be informed about the potential for recurrence, the importance of postoperative care, and the need for follow-up assessments.
