PMC7201622_01
Illustrates the corneal lesion 7 days after hospitalization. Notice the dry, white, caseous exudate and the sharply defined furrow at the border of the infected and non-infected cornea
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Fig1
Day 7 after admission it had degraded into a 25 mm diameter cornea lesion with the loss of approximately 60% of the stroma at the deepest aspect, and characterized by a dry, white, caseous exudate ("cake-frosting" appearance) typical of mycotic infections with a sharply defined furrow at the border of the infected and non-infected cornea (Fig. 1). Due to the clear progression of the problem despite the aggressive medical therapy, surgical intervention was then recommended, and a conjunctival pedicle graft was performed. 
Intraoperative photograph illustrating the pedicle conjunctival flap created to cover the ulcer
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Fig2
The conjunctiva was then sutured to the cornea using 6-0 polyglactin 910 in a simple interrupted suture pattern (Fig. 2).
Appearance of the eye 7 days after the conjunctival flap. Note the graft had partially dehisced, the progressive corneal stromal liquefaction, and the presence of a central lateral focal descemetocele (bulging Descemet's membrane)
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Fig3
The corneal ulcer had enlarged (90% of the cornea diameter was now involved) and liquefaction (melting) was present with approximately 85% of corneal stroma loss, and a central lateral focal descemetocele of 5 mm diameter (Fig. 3).
Intraoperative photograph illustrating the donor site at the time of fascia lata harvest in a pony
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Fig4
A 5 cm long proximodistal incision was made through the skin on the craniolateral aspect of the mid-thigh and the subcutaneous tissues were bluntly dissected to reveal the fascial sheath tissue surrounding the right thigh muscles (Figs. 4, 5).
Photograph illustrating the donor site after two weeks of healing in pony
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Fig5
A 5 cm long proximodistal incision was made through the skin on the craniolateral aspect of the mid-thigh and the subcutaneous tissues were bluntly dissected to reveal the fascial sheath tissue surrounding the right thigh muscles (Figs. 4, 5).
Intraoperative photograph illustrating the fascia lata graft covering the ulcer
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Fig6
The graft was sutured into position using 6-0 polyglactin 910 in a simple interrupted pattern (Fig. 6).
Illustrates the eye's appearance 30 days after hospitalization (i.e. 16 days after corneal grafting). The fascial graft was degrading as a result of autolysis
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Fig7
Over the next 2 days, the graft continued to degrade and the eye remained comfortable (Fig. 7).
Illustrates the appearance of the eye at the time of discharge from the Hospital, 31 days after arrival and 17 days after fascia lata grafting. The graft has almost completely sloughed and the eye globe is stable without any evidence of corneal perforation
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Fig8
On day 17 after the second surgery (Day 31 of hospitalization) the graft had completely sloughed off (Fig. 8) and the remaining sutures were removed.
The appearance of the eye one year after discharge. Note the central corneal fibrosis and the partially pigmented conjunctival flap that was left after dehiscence of the first conjunctival pedicle graft
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Fig9
The owner was pleased to have saved the globe, despite this low visual outcome (Fig. 9).