Treatment of Bilateral Corneal Ulcers in an African Lioness Using Human Amniotic Membrane Allografts
An 18-year-old spayed female African lioness (Panthera leo) developed bilateral ulcerative keratoconjunctivitis, which was suspected to be secondary to depressed lacrimal function. The lioness was under treatment with steroids (prednisolone 1 mg/kg PO SID) for immune mediated anemia. The animal was treated with pilocarpine (0.02 mg/kg PO BID) to enhance tear production and oral systemic antibiotics (cephalexin 20 mg/kg PO BID). Two weeks later, bilateral allografts (OASIS Acelagraft Dehydrated Human Amniotic Membrane; www.oasismedical.com) were applied to the left and right corneal ulcers and were sutured in place. Subconjunctival injections of flurbiprofen and gentamicin were performed. Complete corneal healing, with corneal scars, were documented 5 weeks postsurgically. The animal died from unrelated causes, and a necropsy was performed.
Ulcerative corneal lesions occur in many species, including humans, domestic and exotic animals. Predisposing causes include trauma, suboptimal tear film production and/or composition due to aging or other reasons, immune system compromise, or immunosuppressive therapy. Prompt and effective repair of corneal defects is desirable in order to maintain or restore vision.1,2 Human amniotic grafts have been used as a biologic membrane to repair corneal defects in humans.3 The membrane provides mechanical protection, decreases the inflammatory response, acts as a basement membrane layer, contains growth and trophic factors, and expands the limbal stem cell population. In this case, histologic examination confirmed the presence of an effective healing response, through the use of this commercially available human product.
The authors thank Colleen Grace, MD for significant contributions to this paper and presentation, and Robert Hill for documentation of the surgical procedure.
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