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

Corneal perforation, not graft type, is the strongest predictor of postoperative corneal opacity in dogs.

This retrospective cohort study evaluated prognostic factors influencing postoperative corneal clarity in 76 dogs (78 eyes) undergoing corneal reconstruction for deep stromal or perforating corneal defects. 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 assess postoperative outcomes. Corneal perforations were present in 31 eyes, with a median graft size of 5 mm. Seven eyes required revision surgery, all from the xenogeneic grafting group. Corneal opacities were identified in 71 of 78 eyes, indicating a high overall rate of postoperative opacity regardless of technique. Univariate analysis (Mann-Whitney U test) identified corneal perforation as significantly associated with increased postoperative graft opacity (p = 0.04). However, graft type, brachycephalic conformation, graft size, and bacterial infection were not significantly associated with postoperative corneal clarity. Multivariable logistic regression failed to identify any independent predictors of postoperative corneal clarity. The authors conclude that disease severity at presentation—particularly the presence of corneal perforation—has a greater influence on postoperative transparency than the choice of graft material. These findings suggest clinicians should counsel owners that perforation cases carry a higher risk of persistent corneal opacity, and that no single surgical technique has been shown to yield superior clarity outcomes in this population.

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