Predictors of Postoperative Corneal Clarity After Corneal Reconstruction for Deep Corneal Ulcers and Perforations in...

This study aimed to identify factors associated with postoperative corneal clarity in dogs undergoing corneal transplantation for deep stromal or perforating corneal defects.

A total of 76 dogs (78 eyes) treated surgically for deep stromal or perforating corneal defects were evaluated.

The medical records of dogs who underwent corneal reconstruction between January 2019 and August 2025, anonymized for review, were retrospectively reviewed. A total of 78 eyes were evaluated; surgical techniques included autologous corneal grafting (23 eyes), corneo-limbo-conjunctival transposition (CLCT; 13 eyes), and xenogeneic corneal grafting (42 eyes). The corneal clarity score (CCS) was used to grade postoperative corneal clarity. Associations between CCS and potential prognostic factors, including the graft type, brachycephalic conformation, corneal perforation, graft size, and bacterial infection, were assessed using the Mann-Whitney U test and logistic regression analysis.

Corneal perforations were observed in 31 eyes, with a median graft size of 5 mm. Seven eyes required revision surgery, all of which had previously undergone xenogeneic corneal grafting. Corneal opacities were identified in 71 eyes. The graft type, brachycephalic conformation, graft size, and bacterial infection were not significantly associated with postoperative corneal clarity (p > 0.05). Conversely, corneal perforation was considerably associated with increased graft opacity (p = 0.04). However, no independent predictors of postoperative corneal clarity were identified in the multivariable logistic regression analysis.

Postoperative corneal clarity in dogs is influenced more by disease severity, particularly corneal perforation, than by graft material.