Update (July 5, 2026): Superficial Keratectomy for SCCED in Dogs — 99% Single-Procedure Healing (Irving 2025)

Bottom line

• In 107 dogs (121 SCCEDs), superficial keratectomy achieved 99% (120/121) healing within 21 days with zero postoperative complications — the highest single-procedure closure rate reported for this lesion [1].
• Diamond-burr debridement (DBD) remains the standard of care but heals ~67–77% of eyes after one treatment; adding a grid keratotomy does not improve outcomes over DBD alone [2][3].
• This is uncontrolled retrospective evidence from a specialist referral setting — treat it as a signal that keratectomy is a high-yield salvage/first-line option in trained hands, not as a mandate to abandon DBD in general practice.

Clinical facts

• What a SCCED is. A spontaneous chronic corneal epithelial defect (SCCED; boxer ulcer, indolent ulcer, refractory corneal erosion) is a superficial, non-infected ulcer that fails to re-epithelialize because a redundant, non-adherent epithelial lip cannot bond to an abnormal anterior stromal layer. It is a defect of adhesion, not of infection or depth.
• Why simple debridement is not enough. Cotton-tipped debridement alone removes the loose epithelium but leaves the aberrant stromal surface, so recurrence is common. The established mechanical solutions — grid/punctate keratotomy, DBD, and superficial keratectomy — all work by disrupting or removing that abnormal anterior stroma to create an adherable bed.
• Superficial keratectomy removes a thin lamella of anterior stroma (roughly one-fifth corneal depth in the anchor study) under operating-microscope guidance, followed by a bandage contact lens [1]. It is the most aggressive of the three and has historically been reserved for DBD/keratotomy failures because it requires magnification, sedation or general anesthesia, and surgical skill.
• The comparators. DBD is a rotary burr that abrades non-adherent epithelium and superficial stroma chairside; grid keratotomy scores the stroma with a needle. Both are widely performed in general practice.

For a case-specific read on whether keratectomy, DBD, or continued medical management fits a given patient, ask Voyage ForVets about this study.

What the evidence shows

Anchor study — Irving et al., Veterinary Ophthalmology 2025 [1]. This multi-surgeon retrospective evaluated superficial keratectomy in 107 dogs with 121 SCCEDs (mean age 8.3 years). Keratectomy was performed to approximately one-fifth of corneal depth under the operating microscope, with a bandage lens placed immediately and healing assessed by fluorescein staining. Ninety-nine percent (120/121) of SCCEDs healed with no additional treatment within 21 days, and the single non-healing eye closed two weeks after a Day-14 DBD. Critically, no postoperative complications were noted — no perforation, infection, or clinically significant scarring reported in the cohort. That combination of near-universal single-procedure closure and an absent complication signal is what makes the paper notable.

Supporting evidence — DBD outcomes. The benchmark to beat is DBD, and the largest randomized-comparison data come from Wu et al. 2018 (194 dogs): DBD alone healed 77.4% (82/106) of eyes after the first treatment (mean 13.3 ± 4.9 days) and DBD + superficial grid keratotomy healed 77.3% (68/88) (mean 15.4 ± 5.0 days), with no significant difference between techniques (P = 1) and a 13.3% complication rate in single-treatment eyes [2]. A more recent large retrospective, McKeever et al. 2026 (521 dogs, 598 eyes), reported a lower real-world single-DBD success of 67.7% (405/598), with French bulldogs showing reduced odds of normal healing [3]. Across the DBD literature, first-pass healing clusters in the high-60s to low-90s percent depending on case mix and recheck timing.

How to read the delta. The 99% keratectomy figure sits above the DBD range, and the reported complication rate is lower — but the comparison is indirect. Irving 2025 and the DBD studies are separate retrospective cohorts with different populations, surgeons, and follow-up windows; there is no head-to-head randomized trial of keratectomy versus DBD. The keratectomy series also reflects specialist referral practice with microscope access, which self-selects for technique quality.

How this fits clinical practice

• DBD stays first-line in general practice. It is chairside, requires no microscope, heals two-thirds to three-quarters of eyes on the first pass, and its failures are recoverable [2][3]. Nothing in the anchor study displaces it as the pragmatic starting point for most clinicians.
• Skip the grid. The Wu data show adding a superficial grid keratotomy to DBD confers no healing advantage and no complication penalty, so the extra step is hard to justify on evidence [2]. Recurrent-ulcer protocols that still default to DBD + grid should be revisited.
• Position keratectomy as the high-yield escalation. For DBD failures — or as a primary option where operating-microscope surgery is available — superficial keratectomy offers the best-documented single-procedure closure rate in the current literature [1]. The near-zero complication signal, if it holds in prospective work, weakens the traditional "reserve it because it's risky" argument.
• Set expectations by signalment. Breed matters: French bulldogs healed less reliably and had more complications after DBD in the 2026 cohort, a useful prognostic flag when counseling owners and choosing between chairside and surgical approaches [3].
• What is still missing. No randomized keratectomy-versus-DBD trial exists, complication reporting is retrospective, and long-term scarring/visual outcomes are not systematically compared. The 99% number is a strong hypothesis-generator, not level-1 proof.

Want the comparison mapped onto a specific presentation — breed, prior DBD attempts, equipment on hand? Ask Voyage ForVets to work through the options.

This brief summarizes published evidence for veterinary professionals and does not replace individual clinical judgment, hands-on ophthalmic assessment, or referral where indicated.

References

1. Irving W, McCarthy P, Reynolds B, Whittaker C, Caruso K, Smith J, Annear M. Superficial keratectomy for the treatment of spontaneous chronic corneal epithelial defects in dogs. Veterinary Ophthalmology. 2025;28(2):275-280. https://pubmed.ncbi.nlm.nih.gov/38468142/
2. Wu D, Smith SM, Stine JM, et al. Treatment of spontaneous chronic corneal epithelial defects (SCCEDs) with diamond burr debridement vs combination diamond burr debridement and superficial grid keratotomy. Veterinary Ophthalmology. 2018;21(6):622-631. https://pubmed.ncbi.nlm.nih.gov/29536611/
3. McKeever F, Mitchell N, Lowe R, McAloon C. Clinical outcomes following diamond burr debridement of spontaneous chronic corneal epithelial defects: a retrospective study of 521 dogs. Veterinary Ophthalmology. 2026;29(2). https://pubmed.ncbi.nlm.nih.gov/41623201/

Changelog

• 2026-07-05: First published.