Diamond burr debridement of calcific band keratopathy in 24 eyes of 22 horses

Purpose: To evaluate the safety and effectiveness of diamond burr debridement (DBD) for the treatment of calcific band keratopathy (CBK) in horses.

Methods: Medical records from horses with CBK were reviewed over a period of 4 years. Diagnosis of CBK was based on slit-lamp examination findings, and DBD was performed on standing sedated horses. Follow-up was obtained by clinical reevaluation of the treated eyes or a telephone survey with the referring veterinarian.

Results: Twenty-two horses of different ages (median: 11 years; range: 5-23) representing 24 CBK-affected eyes (14 left eyes and 10 right eyes) were included in the study. The patients had a medical history of chronic and recurrent uveitis, which required repeated long-term treatments with various combinations of ophthalmic corticosteroids. DBD alone cleared the cornea in 22 affected eyes (92%), but it was combined with blade scraping in two cases with thick calcium plaques. The postoperative medication included a topical antibiotic, atropine drops, and oral flunixin meglumine. Corneal healing was achieved in 21 eyes (87%), 5-21 days (median time 13 days) postoperatively. The three remaining horses were lost to follow-up. Recurrence occurred in 5 of the 21 (24%) reexamined eyes, 3-12.5 weeks (median 8 weeks) postoperatively, and required a second DBD. Four of the 21 eyes ended up being enucleated due to sequelae of uveitis. The main limitations of the study include those inherent to all retrospective clinical data collections.

Conclusion: Mechanical DBD can readily and safely clear the cornea in horses with CBK, but recurrence of calcium deposition is possible.