Comparison of outcomes in cataractous eyes of dogs undergoing phacoemulsification versus eyes not undergoing surgery

Traction suture fixation technique using a capsular tension ring fragment for severe lens displacement during cataract surgery in dogs

OBJECTIVES

To describe the traction suture fixation technique for severely displaced lenses (≥180°) using a capsular tension ring (CTR) fragment during cataract surgery in dogs, and to retrospectively investigate its clinical outcomes.

ANIMALS STUDIED

Eight dogs (nine eyes).

PROCEDURES

The medical records of dogs with severe lens displacement (≥180°) due to cataracts that underwent traction suture fixation during cataract surgery using a CTR fragment at the Grand Animal Hospital (Hyogo, Japan) between November 2019 and September 2022 were retrospectively reviewed. The retrieved data included the signalment, type of CTR, and postoperative outcomes.

RESULTS

A single CTR fragment was used to fix the capsular bag to the sclera in six eyes, and two CTR fragments were used at two sites in three eyes. The lengths of the CTR fragments used were 1 one-fifth fragment, 3 one-fourth fragments, and 8 one-third fragments. Postoperative complications included uveitis (nine eyes), glaucoma (one eye), posterior iris adhesion (one eye), corneal ulcer (one eye), and intracorneal stromal hemorrhage (one eye). Vision was maintained in all dogs during the follow-up period (2 months to 2 years and 8 months) without recurrent capsular bag displacement.

CONCLUSIONS

This technique can correct and stabilize capsular bag displacement relatively easily through a small incision during cataract surgery in dogs with severe lens displacement. Intraocular lens implantation was also possible.

Comparison of the outcomes of phacoemulsification versus topical medication alone in canine diabetic cataracts: a retrospective study

BACKGROUND

Long-term comparisons of phacoemulsification with topical medication are limited in canine diabetic cataracts.

OBJECTIVES

To compare outcomes of eyes submitted to phacoemulsification with those of topical medication for canine diabetic cataracts and identify risk factors for complications.

METHODS

Through medical records review, 150 eyes (76 dogs) with diabetic cataracts were included; 58 eyes (31 dogs) underwent phacoemulsification (phaco-group) and 92 eyes (48 dogs) received ophthalmic solution alone (medication-group). The medication-group was divided into owner-led and vet-led groups depending on who elected not to perform surgery. Comparisons involved time-to-complications, vision, and the number and type of ophthalmic solutions administered. The association between complications and pretreatment clinical findings was investigated.

RESULTS

No difference was found in complication risk between the phaco and owner-led medication groups. Conversely, the vet-led medication-group had a higher complication risk than the other groups. At the last follow-up, 94.8% of the phaco-group had vision, whereas 7.6% of the medication-group restored some visual axis. Poor glycemic control in the medication-group and younger age in the phaco-group increased complication risk. At 1-year post-treatment, the average number of ophthalmic solutions administered was 1.7 and 2.6 in the phaco and medication groups, respectively. The medication-group used anti-inflammatories the most throughout the follow-up, whereas the phaco-group used anti-inflammatories the most until 1-year post-treatment and lacrimostimulants at 1.5-year post-treatment.

CONCLUSIONS

For canine diabetic cataracts, phacoemulsification is recommended because it is superior to topical management alone in terms of maintaining vision and reducing the number of ophthalmic solutions required in the long term.

Retrospective Study of Long-Term Outcome of Phacoemulsification in 22 Feline Eyes with Presumed Congenital/Juvenile Cataracts (2007-2020)

The objective of this study was to determine the complication risk and prevalence after phacoemulsification in cats with presumed congenital/inherited cataracts. Twelve client-owned cats were included in the study. This retrospective study spanned 13 yr and involved 22 eyes. The median age at the time of surgery was 15 mo (range: 4.5-168 mo of age). Recorded complications were 3 eyes developed postoperative ocular hypertension, 1 eye developed glaucoma, 7 eyes developed feline herpes virus-1 signs, and 7 eyes developed postoperative uveitis >2 wk after surgery. No eyes had developed intraocular sarcomas at the time of their last exam. All eyes remained visual at last follow-up (range: 0.5-121 mo). Success was defined as a comfortable and visual eye without intraocular neoplasia, glaucoma, a partial or complete retinal detachment, or uveitis that occurred >2 wk after surgery or persisted longer than 2 wk. Twenty-one out of 22 eyes had a successful outcome. In this study, cats with presumed congenital/juvenile cataracts who underwent phacoemulsification had an excellent outcome.

Retrospective evaluation of phacoemulsification and aspiration in 182 eyes: Visual outcomes and CDE-predictive value

OBJECTIVE

To determine the effect of cumulative dissipated energy (CDE) on complications and visual outcome following cataract surgery in dogs.

ANIMALS STUDIED

Records of 182 canine eyes that had undergone cataract surgery.

PROCEDURES

Retrospective medical record review was conducted on dogs that underwent unilateral or bilateral elective cataract surgery by a single surgeon. Preoperative variables such as age, cataract duration, and pre-existing conditions were recorded. Intraoperative variables such as intraocular lens (IOL) status, phacoemulsification time, average power, irrigation fluid volume, and CDE were recorded. Postoperative complications and visual status at last follow-up were compared to these variables.

RESULTS

Eighty-six percent of dogs were visual in one or both eyes at last follow-up (LFU) examination. Median follow-up time was 186 days postoperatively. Eyes that developed glaucoma had a significantly greater mean CDE (77.73 ± 80.11) than eyes that did not develop glaucoma (49.21 ± 38.93). Eyes that remained visual at the LFU examination had a significantly lower mean CDE (48.31 ± 37.14) than eyes that were blind at LFU (82.05 ± 82.73). Significantly lower mean CDEs were found in diabetic eyes, younger eyes, early-operated eyes (<1 month duration), and eyes with preoperative lens-induced uveitis.

CONCLUSIONS

Higher CDE may be associated with an increased risk of postoperative glaucoma and loss of vision in dogs. Cumulative dissipated energy may be a useful prognostic indicator for success of canine cataract surgery.

Cataracts and phacoemulsification in the Siberian Husky: A retrospective and multicentric study (2008-2018)

PURPOSE

To compare cataract characteristics and complications related to cataracts and phacoemulsification in the Siberian Husky (Huskies) versus other canine breeds (non-Huskies).

ANIMALS

A total of 50 Huskies (92 eyes) and 96 non-Huskies (182 eyes) were evaluated.

METHODS

Medical records of Huskies (at four university veterinary hospitals, 2008-2018) and non-Huskies (Colorado State University, 2017-2018) diagnosed with cataracts were reviewed. Age of dog, cataract stage at presentation, and pre- and post-operative complications were recorded and analyzed.

RESULTS

Mean (±standard deviation) age at presentation was significantly lower in Huskies (3.5 ± 3.3 years) compared to non-Huskies (9.5 ± 2.9 years) (p < .0001). Huskies more commonly presented with hereditary cataracts than non-Huskies (84% versus 52%) and a significantly higher percentage of non-Huskies presented with diabetic cataracts than Huskies (48% versus 16%; p = .0001). Cataract stage at presentation did not differ between Huskies and non-Huskies. Phacoemulsification was performed in 40% (20 out of 50 dogs, 39 out of 92 eyes) of Huskies and 42% (40 out of 96 dogs, 74 out of 182 eyes) of non-Huskies. Pre-operative and post-operative retinal detachment were more common in Huskies than non-Huskies (13% versus 2% and 10% versus 1%, respectively) but the difference was not significant. Other post-operative complications occurred with similar frequency in both groups (p ≥ .17).

CONCLUSIONS

Huskies evaluated for cataracts were younger and less likely to present with diabetic cataracts than other canine breeds and, although not statistically significant, had a clinically important increased risk of retinal detachment pre- and post-phacoemulsification.

Estimation of planning organ at risk volumes for ocular structures in dogs undergoing three-dimensional image-guided periocular radiotherapy with rigid bite block immobilization

Planning organ at risk volume (PRV) estimates have been reported as methods for sparing organs at risk (OARs) during radiation therapy, especially for hypofractioned and/or dose‐escalated protocols. The objectives of this retrospective, analytical, observational study were to evaluate peri‐ocular OAR shifts and derive PRVs in a sample of dogs undergoing radiation therapy for periocular tumors. Inclusion criteria were as follows: dogs irradiated for periocular tumors, with 3D‐image‐guidance and at least four cone‐beam CTs (CBCTs) used for position verification, and positioning in a rigid bite block immobilization device. Peri‐ocular OARs were contoured on each CBCT and the systematic and random error of the shifts in relation to the planning CT position computed. The formula 1.3×Σ+0.5xσ was used to generate a PRV of each OAR in the dorsoventral, mediolateral, and craniocaudal axis. A total of 30 dogs were sampled, with 450 OARs contoured, and 2145 shifts assessed. The PRV expansion was qualitatively different for each organ (1‐4 mm for the dorsoventral and 1‐2 mm for the mediolateral and craniocaudal axes). Maximal PRV expansion was ≤4 mm and directional for the majority; most pronounced for corneas and retinas. Findings from the current study may help improve awareness of and minimization of radiation dose in peri‐ocular OARs for future canine patients. Because some OARs were difficult to visualize on CBCTs and/ or to delineate on the planning CT, authors recommend that PRV estimates be institution‐specific and applied with caution.

Association between preoperative gonioscopic status and postoperative glaucoma after phacoemulsification in dogs: A retrospective cohort study of 505 eyes

OBJECTIVE

To assess whether preoperative gonioscopy status is associated with the development of postoperative glaucoma after phacoemulsification.

PROCEDURE

Eligible dogs and eyes were selected from medical records (2007-2017), and each eye was classified as having normal or abnormal gonioscopy status. Records were examined for postoperative glaucoma, and data were collected for baseline variables including patient signalment, surgical factors, and pre, intra, and postoperative medications.

RESULTS

Of 305 dogs (505 eyes) selected for review in this study, 111 dogs (163 eyes) had abnormal gonioscopy findings, and 194 dogs (342 eyes) had normal gonioscopy findings. Postoperative glaucoma occurred in 24% (39/163) of eyes with abnormal gonioscopy and in 14% (49/342) eyes with normal gonioscopy. Eyes with abnormal gonioscopy status were at higher risk of postoperative glaucoma compared to normal eyes (P = .025). There was no important confounding due to the numerous baseline variables summarised above. Regardless of gonioscopy status, the risk of glaucoma was highest during the first 2 months after surgery.

CONCLUSIONS

Eyes with abnormal gonioscopy findings are at increased risk of postoperative glaucoma compared with eyes with normal gonioscopy findings. Gonioscopy is recommended as a part of presurgical assessment in all dogs prior to phacoemulsification. Further study is needed to assess whether the incidence of postoperative glaucoma can be reduced by increased monitoring or altered treatment protocols in cases that are known to have abnormal gonioscopy findings prior to cataract surgery.