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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., (© 2024 American College of Veterinary Ophthalmologists.)

Purpose: To evaluate immediate effects of diamond burr debridement (DBD) on the cornea of canine patients diagnosed with spontaneous chronic corneal epithelial defects (SCCEDs)., Animals Studied: Eight client owned dogs with SCCEDs., Methods: Nine eyes from eight dogs with SCCEDs underwent superficial keratectomy (SK). The ulcerated area was divided into quadrants with a 300-micron restricted depth knife. Two of four quadrants underwent DBD for 40-60 s. A SK followed immediately. One burred section and one nonburred section were fixed with formaldehyde 10% and underwent light microscopy (LM). The remaining quadrants from five eyes were fixed with glutaraldehyde 2.5% and underwent transmission electron microscopy (TEM). Masked pathologists evaluated the samples. A student's paired t-test was used to analyze the data., Results: With LM all nonburred samples had a superficial stromal hyaline acellular zone (HAZ), seven of the burred samples had an intermittent HAZ and in two burred samples this zone was absent. The HAZ thickness of burred samples (1.062 ± 0.664 μm) was significantly thinner than that of the nonburred samples (4.309 ± 1.348 μm) (P < 0.0001). Transmission electron microscopy showed an absence of basement membrane and the presence of an amorphous, fine fibrillar material in the superficial stroma in nonburred samples. This material was intermittent or absent in burred samples., Conclusion: DBD significantly reduces the superficial stromal HAZ in SCCEDs. A reduction of its thickness may be responsible for the healing rates reported with DBD., (© 2015 American College of Veterinary Ophthalmologists.)

Objectives: To describe the signalment, presence of systemic and/or ocular comorbidities, times to detected healing and probabilities of recurrence after diamond burr debridement (DBD) of eyes with presumed corneal calcareous degeneration and secondary ulceration and/or ocular pain., Animals Studied: Twenty-six dogs with 42 eyes affected, 34 eyes treated with DBD., Methods: A case series was conducted using medical records from a private veterinary ophthalmology referral practice. Dogs were included if they had white or gray corneal opacity consistent with corneal calcareous degeneration with either erosive or superficial ulceration and/or ocular pain in at least one eye and had at least one such eye treated with DBD. DBD was performed with a battery-operated handheld motorized burr (The Alger Company, Inc. Lago Vista, TX, USA), and a bandage contact lens was placed in the majority of eyes (30/34). Eyes were considered healed when the cornea was fluorescein negative, and there were no signs of ocular pain. Patient data (signalment, recurrence) were extracted from medical records., Results: Dogs were first re-examined 7-62 days after treatment (median: 13 days). All DBD-treated eyes healed within 62 days (% healed: 100%; one-sided 97.5% CI: 90-100%, median: 14 days), 82% of eyes (28/34) were healed at first re-examination (median: 13 days after treatment), and all were healed by their second examination (median: 24 days). Of the 34 treated eyes, 11 were lost to follow up; 11 of the remaining 23 eyes recurred. Estimated 1-year recurrence probability was 58% (95% CI: 35-83%). Seven dogs had systemic disease; 7 had a history of prior ocular disease or intraocular surgery., Conclusions: Diamond burr debridement is a safe and effective treatment for rapid resolution of superficial corneal ulceration and ocular pain secondary to presumed corneal calcareous degeneration in dogs., (© 2015 American College of Veterinary Ophthalmologists.)

Objective: To review the signalment, clinical characteristics, and outcome of horses with nonhealing corneal ulcers treated with diamond burr debridement (DBD); and to evaluate the role of ulcer duration, size and location, and bandage contact lens (BCL) placement on healing., Animals: From January 2012-April 2013, 60 horses were diagnosed with ulcers classified as nonhealing based on the presence of raised epithelial margins and duration of at least 7 days., Procedure: Retrospective record review., Results: Average age of included horses was 14.68 years, SD 8.17 years. There were three times as many males (45) as females (15), (χ12 = 15, P = 0.001). Forty-eight horses (80%) had nonhealing ulcers uncomplicated by associated corneal disease. In the remaining horses, associated corneal disease included esinophilic keratitis (10%), calcific band keratopathy (5%), endothelial decompensation (1.67%), habronemiasis(1.67%), and lid suture abrasion (1.67%). Average corneal ulcer duration prior to diamond burr debridement (DBD) was 29.0 days (n = 56). Ulcers occurred most commonly in the axial cornea (41%). Fifty-five of 60 horses (92%) healed with DBD. Healing time, defined as time to epithelialization following DBD, averaged 15.5 days, SD 9.32 days, and was not correlated with patient age or ulcer duration, location, or size prior to or following DBD. Healing time was significantly longer for eyes in which a BCL had been placed (n = 28, 19.0 days) than for eyes without a BCL (n = 32, 12.9 days), F(1,58) = 5.543, P = 0.02. DBD was considered a failure for five horses (8%)., Conclusions: DBD may be an effective treatment for nonhealing corneal ulcers in horses., (© 2014 American College of Veterinary Ophthalmologists.)