Development of glaucoma after cataract surgery in dogs: 220 cases (1987-1998)

OBJECTIVE: To examine postoperative ocular hypertension (POH) and other variables as predictors of the risk of developing glaucoma after cataract surgery in dogs. DESIGN: Retrospective study. ANIMALS: 220 dogs that had cataract surgery. PROCEDURE: Medical records of 220 dogs (346 eyes) that had extracapsular cataract removal or phacoemulsification of cataracts were reviewed. With respect to glaucoma development, 8 variables were analyzed, which included development of POH, breed, sex, age at time of surgery, eye (right vs left), phacoemulsification time, intraocular lens (IOL) placement (yes or no), and stage of cataract development. Eyes developed glaucoma within 6 or 12 months of surgery or did not have signs of glaucoma at least 6 or 12 months after cataract surgery. RESULTS: Of 346 eyes, 58 (16.8%) developed glaucoma after surgery. At 6 months, 32 of 206 (15.5%) eyes examined had glaucoma; at 12 months, 44 of 153 (28.8%) eyes examined had glaucoma. Median follow-up time was 5.8 months (range, 0.1 to 48 months). Mixed-breed dogs were at a significantly lower risk for glaucoma, compared with other breeds. Eyes with IOL placement were at a significantly lower risk for glaucoma, compared with eyes without IOL placement. Eyes with hypermature cataracts were at a significantly higher risk for glaucoma, compared with eyes with mature or immature cataracts. CONCLUSIONS AND CLINICAL RELEVANCE: Multiple factors appear to contribute to the onset of glaucoma in dogs after cataract surgery. Complications prohibiting IOL placement during cataract surgery may lead to a high risk of glaucoma development.     

Development of glaucoma after phacoemulsification for removal of cataracts in dogs: 22 cases (1987-1997)

OBJECTIVE: To determine factors contributing to glaucoma after lens extraction via phacoemulsification in dogs. DESIGN: Retrospective study. ANIMALS: 22 dogs (29 eyes) with glaucoma and 21 dogs (30 eyes) without glaucoma after phacoemulsification. PROCEDURE: Medical record review. RESULTS: Eyes at increased risk for glaucoma included those of Boston Terriers, those with uveal or retinal abnormalities before surgery, and those with intraoperative intraocular hemorrhage. Significant differences between groups were not detected for incidence of preoperative lens-induced uveitis, presence of an intraocular lens, or frequency of an acute postoperative increase in intraocular pressure. Glaucoma developed (mean +/- SD) 12.8+/-14.1 months (median, 10 months; range, 0.25 to 55 months) after surgery. Eighteen of 29 (62%) eyes with potential for vision after onset of glaucoma retained vision for a mean of 16.5+/-12.8 months (median, 10.8 months; range, 1.5 to 37 months) after glaucoma was diagnosed. Most of these eyes still had vision at the conclusion of the study period. CONCLUSIONS AND CLINICAL RELEVANCE: Risk factors identified by this study will aid in preoperative counseling of clients and refining selection criteria for candidates for phacoemulsification. Careful follow-up for the remainder of the dog's life after surgery may improve long-term success rates by permitting early intervention before intraocular pressure increases substantially and vision is irreversibly lost. Surgery for cataracts may still be worthwhile in dogs with increased risk of glaucoma, especially if elderly, because of the lengthy period to onset of glaucoma after surgery and the beneficial effects of treatment after glaucoma develops.     

Cataracts are not associated with retinal detachment in the Bichon Frise in the UK--a retrospective study of preoperative findings and outcomes in 40 eyes

Objective The aim of this study was to evaluate whether the Bichon Frise population in the UK is at the same risk of developing retinal detachment in association with cataract formation and following phacoemulsification as described in reports from the USA. Procedures The medical records of Bichon Frises which were presented for cataract assessment and of those which were treated with phacoemulsification at Willows Referral Service between 1997 and 2009 were reviewed. Results Forty eyes (26 dogs) with unilateral or bilateral cataracts were included in the study. There was no evidence of retinal detachment associated with the cataracts at initial presentation. Phacoemulsification was performed on 34 eyes (20 dogs). Clinically evident lens‐induced uveitis was treated preoperatively in 17/34 eyes. Artificial lens implantation was carried out in 30/34 eyes; automated anterior vitrectomy was performed in 7/34 eyes. The mean follow‐up time was 16.6 months (range 1.5–73 months). At the last re‐examination, 31/34 eyes (91.2%) were visual. Three eyes (8.8%) were blind – two (in the same dog) because of presumptive bilateral optic nerve disease and one because of uveitis and secondary glaucoma. There was no evidence of retinal detachment following phacoemulsification in any of the 34 eyes. Conclusion This study suggests that the Bichon Frise population in the UK does not appear to have a predisposition for retinal detachment in association with cataract formation or following cataract surgery. Prophylactic random transscleral laser retinopexy or transscleral cryopexy cannot therefore be routinely recommended for Bichon Frises with cataracts in the UK.     

Evaluation of client perceptions concerning outcome of cataract surgery in dogs

OBJECTIVE: To compare client perception of outcome of phacoemulsification in dogs with information obtained from medical records. DESIGN: Retrospective cohort study. ANIMALS: 108 dogs (203 eyes) undergoing phacoemulsification from May 1999 through April 2004. PROCEDURE: Data obtained from medical records included signalment, presence of diabetes mellitus, cataract stage, whether surgery was unilateral or bilateral, intraocular lens (IOL) placement, and postoperative complications. Owners completed a survey concerning outcome of phacoemulsification in their dog. Survey responses from owners classified as satisfied or dissatisfied with the outcome of phacoemulsification on the basis of their willingness, in retrospect, to have the surgery performed again were compared. RESULTS: Data from medical records and survey responses were available for 108 dogs (203 eyes). Median follow-up was 3 months via medical record review and 12 months via owner survey responses. Most (81%) owners were satisfied with outcome. The most common reason for dissatisfaction was loss of vision after surgery; however, most dissatisfied owners did not return their dog for examinations. Owner perception of success was not associated with patient age, sex, presence of diabetes mellitus, cataract stage, or IOL placement in at least 1 eye but was associated with perceived improvement of their pet's vision and activity level. Dissatisfied owners were significantly more likely to report that explanation of risks and complications before surgery was inadequate. CONCLUSIONS AND CLINICAL RELEVANCE: Owner perception of outcome after phacoemulsification in dogs was highly favorable. However, surgical risks and the importance of postoperative examinations, particularly in dogs undergoing visual deterioration, must be conveyed to clients.     

Cataracts in 44 dogs (77 eyes): A comparison of outcomes for no treatment, topical medical management, or phacoemulsification with intraocular lens implantation

Outcomes for 77 cataractous eyes were compared after each eye underwent no treatment, topical medical treatment only, or phacoemulsification with intraocular lens implantation. Median follow-up time for all dogs was 2.3 y. Failure occurred in all untreated eyes and the rate of failure was 65 and 255 times higher than in medically and surgically treated eyes, respectively. The failure rate was 4 times higher in dogs receiving only medical treatment compared with dogs that received surgery. Across all groups, the success rate for mature and hypermature cataracts was lower than for immature cataracts. Regardless of cataract stage, the chance of success was higher for eyes undergoing phacoemulsification than for eyes that received medical management only. Results of this study support prompt referral for phacoemulsification when cataracts are diagnosed in dogs or, if referral is not possible, topical anti-inflammatory therapy.     

Canine cataracts, diabetes mellitus and spontaneous lens capsule rupture: a retrospective study of 18 dogs

OBJECTIVE: To describe the clinical presentation and surgical outcome of diabetic canine patients with cataracts and preoperative spontaneous lens capsule rupture. ANIMALS STUDIED: A total of 20 dogs and 40 eyes were included in the retrospective evaluation. The patients' ages ranged from 5 to 14 years (mean 8.5 years). RESULTS: All dogs had clinical diabetes mellitus, with the duration since diagnosis ranging from 30 to 240 days (mean 123 days). Cataracts were bilateral and noted to have been present for 14-112 days (mean 39 days). Of the 40 eyes affected with cataracts, 30 had a spontaneous rupture of the lens capsule prior to surgery. The capsular rupture was diagnosed on clinical examination in 28/30 eyes and was noted intraoperatively in 2/30. The location of the capsular rupture was equatorial in 29/30 and posterior in 1/30 eyes. Surgery was performed in 38/40 eyes, with one case lost to follow-up without surgical intervention. Prior to surgery, routine diagnostic ophthalmic examination, ocular ultrasound, electroretinography, and systemic evaluation were performed in all dogs. Surgical procedures included phacoemulsification in 28/40 eyes, with IOL placement performed in 20/28 eyes. Intrascleral prosthesis placement or enucleation was performed in 8/40 and 2/40 eyes, respectively, due to a significantly reduced ERG or secondary glaucoma. CONCLUSIONS: The duration of clinical follow-up (19/20 dogs) ranged from 1 to 36 months (mean 12.9 months). All eyes that had cataract surgery with or without IOL placement were sighted at the time of the last follow-up examination. Spontaneous lens capsule rupture associated with diabetes mellitus, cataract and rapid lens intumescence occurs in the dog. Early surgical intervention, prior to secondary complications of glaucoma and loss of retinal function, is associated with a favorable outcome.     

Chronic ocular lesions in tawny owls (Strix aluco) injured by road traffic

The chronic ocular lesions suffered by 50 tawny owls (Strix aluco) injured by road traffic were investigated. They included non-healing corneal erosions, cataracts and retinal scarring, and periretinal membrane formation. The intraocular pressure was significantly lower in the eyes with intraocular inflammatory pathology and higher in the eyes with irido- or cyclodialysis than in ophthalmically normal eyes. Cicatritial retinal lesions were not associated with high titres of antibodies to Toxoplasma species. The findings correlate with those observed in human beings with eye injuries due to high-speed blunt trauma.     

Cataract surgery with foldable intraocular lens implants in captive lowland gorillas (Gorilla gorilla gorilla).

Two juvenile, male, captive-born lowland gorillas (Gorilla gorilla gorilla) with the same father but different mothers developed bilateral cataracts. The cataracts were surgically removed within 6 yr and 3 mo, respectively, of diagnosis, and foldable intraocular lenses were implanted. Although vision was not restored in one eye with a mature, 6-yr-old cataract in gorilla A, surgical intervention on the other eye was performed before a complete cataract developed, and vision was fully restored. Gorilla B was treated at the age of 17 mo, and normal visual development proceeded in both eyes. This animal developed bilateral after-cataract and therefore needed a second intervention in both eyes using Nd:YAG laser treatment. The genetic component of juvenile cataracts should be considered in breeding management programs.     

Ultrasonographic abnormalities in eyes with traumatic hyphema obscuring intraocular structures: 33 cases (1991–2002)

Objective: To examine ultrasonographic abnormalities in eyes with traumatic hyphema obscuring intraocular structures.
Design: Retrospective clinical study.
Setting: The ophthalmology services of a private practice and university veterinary teaching hospital.
Animals: Twenty-two dogs, 6 cats, 3 horses, and 2 birds.
Measurements and main results: Medical records were reviewed for signalment, history, ophthalmic examination, ultrasonographic findings, treatment, and outcome in all patients that presented to the ophthalmology service with trauma-induced hyphema obscuring intraocular structures. Thirty-three patients were included and there were 35 affected eyes (17 left and 18 right). Abnormalities noted on ophthalmic examination included hyphema obscuring intraocular details beyond the iris (100%), corneal laceration (23%), iris prolapse (23%), fibrin clotting within the anterior chamber (17%), and subconjunctival and periocular bruising (17%). Ocular ultrasonography revealed the presence of either vitreous hemorrhage or a retinal detachment in 32 of 35 eyes (91%) with traumatic hyphema. Of the remaining 3 eyes, ocular ultrasonography revealed a lens luxation with posterior eye wall rupture in 1 eye and collapsed globes in the other 2 eyes. Twelve eyes were enucleated and 23 were treated medically. Ten of the medically treated eyes were lost to follow-up. Blindness was noted in all the affected eyes upon their final discharge and recheck examination.
Conclusions: Ocular ultrasonography revealed vitreous hemorrhage or a retinal detachment in 32 eyes (91%) with traumatic hyphema. Blindness was noted on the last available examination of every eye. The prognosis for vision in an eye with traumatic hyphema obscuring intraocular detail is poor.     

Combined cycloablation and gonioimplantation for treatment of glaucoma in dogs: 18 cases (1992-1998)

OBJECTIVE: To evaluate a combined cycloablative and gonioimplantation technique for treatment of glaucoma in dogs. DESIGN: Retrospective study. ANIMALS: 18 adult dogs with glaucoma. PROCEDURE: Medical records of dogs that received a valved gonioimplant and a cyclodestructive procedure (cyclocryoablation or diode laser cyclophotocoagulation) during a 6-year period were reviewed. Retention of vision and intraocular pressure control were assessed, as well as number and nature of complications. RESULTS: 19 eyes of 18 dogs received a valved gonioimplant and either cyclocryoablation (n = 12) or diode laser cyclophotocoagulation (7). At > or = 1 year after surgery, 11 of 19 eyes had vision and 14 of 19 eyes had intraocular pressure < 25 mm Hg. Two dogs (2 eyes) were lost to follow-up 3 and 6 months after surgery. Despite the alternative route for aqueous humor flow created by the gonioimplant, 7 eyes had increased intraocular pressure (27 to 61 mm Hg) < 24 hours after surgery. Other complications included excessive intraocular fibrin, focal retinal detachment, corneal ulcer, retinal hemorrhage, cataract, and implant migration. CONCLUSIONS AND CLINICAL RELEVANCE: Combined cycloablation and gonioimplantation appears to be a promising technique for retention of vision and control of intraocular pressure in dogs with glaucoma.     

Implantation of a foldable intraocular lens in dogs

A 1-piece, tripod-shaped, acrylic intraocular lens was implanted in the posterior chamber after phacoemulsification to remove cataracts in 20 eyes of 16 dogs. Biomicroscopy and intraocular pressure measurements were performed at 1, 8, 30, and 90 days after surgery; retinoscopy was performed at day 30. Complications were not encountered during implantation of the lens. All dogs had mild ocular inflammation characterized predominantly by aqueous flare and mild corneal edema at day 1, which resolved completely by day 8; 3 eyes had mild hyphema at day 1, which resolved by day 8. Three eyes developed fibrin in the anterior chamber, which resolved by day 30. Two eyes developed distorted pupils caused by adherence of vitreous humor or fibrin to the incision site. Postoperative intraocular pressure ranged from 7 to 21 mm Hg. Implantation resulted in 9 emmotropic eyes, 5 myopic eyes, and 6 hyperopic eyes. Maintenance of central lens position was excellent in 19 eyes; in 1 eyes, a disclocated superior haptic at day 2 was easily repositioned.     

Postoperative complications and visual outcomes of phacoemulsification in 103 dogs (179 eyes): 2006-2008

Objective To describe the postoperative complications and visual outcome after phacoemulsification in dogs and identify risk factors for complications. Animals studied One hundred and three dogs (179 eyes) that had phacoemulsification with or without intraocular lens (IOL) placement including foldable acrylic IOLs between March 2006 and March 2008 at Purdue University Veterinary Teaching Hospital. Procedure Medical records were reviewed and occurrence and dates of postoperative complications were tabulated. Visual status at the final recheck during the study period was recorded. Additional information including signalment, diabetes mellitus status, operative complications and factors, presence of prior lens induced uveitis, preoperative retinopexy, and cataract stage was collected. Results The majority of eyes were functionally visual (148 eyes, 82.7%) at the end of the study period. Blindness was seen in 18 eyes (10.0%) with reduced vision in 13 eyes (7.3%) at the final recheck. Postoperative ocular hypertension (22.9%), corneal lipid opacity (19.0%), uveitis (16.2%), intraocular hemorrhage (12.3%), retinal detachment (8.4%), and glaucoma (6.7%) were the most common postoperative complications seen in eyes. The odds of blindness were significantly greater (OR = 290.44) in the eyes of Boston terriers compared with mixed breed dogs and with each year of increasing age (OR = 2.00). Conclusion The prognosis for vision after phacoemulsification with injectable IOL placement is good. Boston terriers were at much higher risk for certain complications.     

Corneal sensitivity and aqueous tear production in dogs undergoing evisceration with intraocular prosthesis placement

OBJECTIVE: To determine whether there is an association between evisceration with intraocular prosthesis placement via a dorsal scleral approach and decreased corneal sensitivity or aqueous tear production in dogs. DESIGN: Prospective study. PROCEDURE: Twenty-one dogs scheduled to undergo unilateral evisceration with intraocular prosthesis, and with a normal normotensive contralateral eye, based on slit-lamp biomicroscopy, indirect ophthalmoscopy and applanation tonometry, were included in the study. Central corneal sensitivity was measured with a Cochet-Bonnet esthesiometer prior to (week 0) and 2, 7, 14 and 28 weeks following surgery. Other pre- and postoperative data collected were Schirmer's tear test (STT I), Schirmer's tear test with topical anesthesia (STT II), corneal fluorescein retention, and intraocular pressure (IOP; postoperative control eye only). Axial globe length was determined for both eyes. Scleral incision length in the surgery eye was also recorded. RESULTS: Corneal sensitivity was significantly lower in eyes undergoing evisceration with intraocular prosthesis than in control eyes both preoperatively and postoperatively at all time points. There was no significant difference between preoperative and postoperative corneal sensitivity within the two groups. There was no significant difference in STT I or STT II-values between control eyes and surgery eyes preoperatively. There was a significant difference between preoperative and 2-week postoperative STT I in the surgery eye. There was a significant difference between the preoperative and 28-week postoperative STT II in the surgery eye. The 28-week postoperative STT I-values differed significantly between control and surgery eyes. Corneal sensitivity tended to decrease with increased degree of buphthalmos or with increased scleral incision length, although neither relationship was statistically significant. CONCLUSIONS: Eyes that have sustained chronically elevated intraocular pressure had decreased axial corneal sensitivity compared to normal eyes, which persisted even after intraocular pressure was reduced. The presence of buphthalmos appeared to be a factor in globes developing decreased corneal sensitivity. Evisceration via a dorsal scleral incision did not result in a significant further reduction in axial corneal sensitivity. A mild reduction in aqueous tear production occurred over time in globes following evisceration with intraocular prosthesis.     

Ophthalmic examination of the captive western lowland gorilla (Gorilla gorilla gorilla).

This study examined the captive western lowland gorilla (Gorilla gorilla gorilla) eye as compared and contrasted with the human eye. Bilateral ophthalmic examinations of western lowland gorillas (n = 5) while under general anesthesia were performed opportunistically, including slit-lamp biomicroscopy, dilated fundus examination, cycloplegic retinoscopy, Schiotz tonometry, corneal diameter and thickness measurements, A-scan and B-scan ultrasonography, keratometry, and cultures of the eyelid margins and bulbar conjunctiva. Mean spherical equivalent refractive error by cycloplegic retinoscopy was +1.20 +/- 0.59 diopters. Mean intraocular pressure by Schiotz tonometry was 12.0 +/- 4.3 mm Hg. Mean optic nerve head cup to disc ratio was 0.42 +/- 0.11. Mean horizontal corneal diameter was 13.4 +/- 0.8 mm, and mean vertical cornea diameter was 12.7 +/- 0.8 mm. Mean central corneal thickness by ultrasound pachymetry was 489 +/- 52 microm. Mean axial length of the eye by A-scan was 22.75 +/- 0.71 mm. Mean lens thickness by A-scan was 4.23 +/- 0.34 mm. Mean anterior chamber depth by A-scan was 4.00 +/- 0.26 mm. Mean keratometry reading was 44.38 +/- 1.64 diopters. Eyelid margin and bulbar conjunctival cultures isolated Candida sp. (n = 5), Staphylococcus aureus (n = 4), Staphylococcus epidermidis (n = 3), Staphylococcus saccharolyticus (n = 3), and Micrococcus sp. (n = 3). This study suggests important similarities between western lowland gorilla and human eyes. These similarities may allow diagnostics, techniques, and equipment for human eye surgery, such as those used for cataract extraction and intraocular lens implantation, to be successfully utilized for gorillas.     

Cataracts in Labrador Retriever and Jack Russell Terrier From the United Kingdom: A Two-Year Retrospective Study

Cataracts are among the most common ocular diseases, and are a leading cause of vision loss in humans and dogs. Jack Russell Terriers (JRT) and Labrador Retrievers (LR) are among the most popular canine breeds in the United Kingdom, and also among the most affected by cataracts.This study aimed to analyze the clinical features and the surgical outcome of cataracts in JRT and LR in an ophthalmologic reference Veterinary Hospital in the United Kingdom. For that purpose, medical records from JRT and LR diagnosed with cataracts between January 2015 and December 2016 were retrospectively evaluated. Data related to identification, clinical history, preoperative features, and surgical outcomes were analyzed.Forty-four dogs (81 eyes), including 26 JRT and 18 LR, were enrolled in the study. Mean ages were 10.2 ± 3.2 years in JRT and 8.5 ± 3.7 years in LR. Twenty-eight (63.6%) were females and 16 (36.4%) were males. Most dogs (84.1%) presented with bilateral cataracts. Nuclear and cortical cataracts were the most prevalent type in both breeds (JRT: n?=?30, 61.2%; LR: n?=?16, 50.0%), although subcapsular cataracts were also frequent in LR (n?=?10, 31.3%). Significant differences in cataract location within the lens were detected between the two breeds (P?=?.002).Senile in JRT (n?=?7) and genetic in LR (n?=?7) were the most common etiologies. Concomitant ocular lesions were more frequent in dogs presented with cataracts in advanced stages, and included lens (n?=?18; JRT: n?=?15; LR: n?=?3) and retinal alterations (n?=?8; JRT: n?=?2; LR: n?=?6), and glaucoma (n?=?6; JRT: n?=?5; LR: n?=?1). Thirty-three animals (75.0%, 51 eyes) were submitted to phacoemulsification with intraocular lens placement. Of these, 28 eyes (54.9%; JRT: n?=?21; LR: n?=?7) were visual, 19 eyes (37.3%; JRT: n?=?11; LR: n?=?8) presented impaired vision and four eyes (7.8%; JRT: n?=?0; LR: n?=?4) were blind at last clinical record. Postoperative complications were detected in 11 eyes (21.6%), and were more frequent in dogs presented with cataracts in advanced stages.These results and the multifactorial nature of cataracts call for further studies to identify and characterize the variables in a broader assessment, including other breeds and influencing factors.     

Congenital ocular anomalies and ventricular septal defect in a dromedary camel (Camelus dromedarius).

A 5-wk-old female dromedary camel (Camelus dromedarius) was clinically diagnosed with bilateral corneal dermoids, incomplete congenital cataracts, a left persistent hyaloid artery (PHA), and a ventricular septal defect (VSD). The corneal dermoids were removed by lamellar keratectomy, and vision improved in the left eye. Thirteen months after dermoid surgery, the calf was presented for enlargement of the right eye. Glaucoma was confirmed in the right eye, and corneal fibrosis and cataract were noted in the left eye. Persistence of the VSD was confirmed by cardiac ultrasonography. The calf was euthanized, and necropsy findings confirmed VSD. Histopathologic examination revealed bilateral corneal thinning and fibrosis, cataracts with retrolental fibroplasia, and retinal dysplasia. Additional changes in the right globe were anterior segment dysgenesis, ruptured lens capsule, chronic phacoclastic uveitis, and retinal separation. The PHA was confirmed in the left eye.     

Phacoemulsification and intraocular lens implantation in a Canada lynx with phacoclastic uveitis

A 4-year-old male Canada lynx (Lynx canadensis) was referred to the ophthalmology service at the University of Saskatchewan with a 7-month history of cataract and chronic phacoclastic uveitis secondary to penetrating trauma from a lynx claw. Ophthalmic examination of the right eye revealed a corneal scar, marked aqueous flare, extensive fibrovascular membranes extending from the iris to the lens, anterior and posterior synechiae, immature cataract, and anterior vitritis; the fundus was not visible. Phacoemulsification surgery and intraocular lens implantation using a custom lens of D+46 and 14 mm (An-vision, West Jordan, Utah, USA) was performed. Post-operative medications included sub-conjunctival injections of atropine, cefazolin, and triamcinolone, and oral doxycycline and prednisolone. At the 5-month follow-up, the uveitis was controlled, and a normal fundus was visualized; at 21 mo, the eye remained comfortable and visual. This is the first case report to describe phacoemulsification in a wild felid as a treatment for a traumatic cataract and severe phacoclastic uveitis.Key clinical message:Despite chronic phacoclastic uveitis, phacoemulsification surgery can provide a positive outcome for mature wild felids with traumatic lens rupture, even when topical treatment cannot be administered.     

Ahmed valve implantation to control intractable glaucoma after phacoemulsification and intraocular lens implantation in a dog

An 11-year-old spayed female Miniature Poodle presented with bilateral senile cataracts. Treatment was cataract removal by phacoemulsification and intraocular lens implantation. Five hours after surgery the operated right eye was partially closed and painful. The right pupil was fully dilated, there was generalized corneal edema, and intraocular pressure (IOP) was increased. After 12 h of medication IOP was controlled. Ten weeks after surgery the owners reported cloudiness of right eye, and the dog was again evaluated. The IOP was again increased and an Ahmed valve was implanted. This case describes describe the progression of this case and benefits of controlling postcataract surgery glaucoma by the implantation of an Ahmed valve.     

A modified ab externo approach for suture fixation of an intraocular lens implant in the dog

The goals of canine cataract and lens instability surgery should be to ensure a small incision, minimal tissue trauma, shortened surgical time, maintenance of the anterior chamber, and restoration of emmetropia through the use of a stable intraocular lens specifically designed for the canine eye. While this is usually the case with routine phacoemulsification and in-the-bag intraocular lens implantation, it is often not the case with lens instability, lens luxation or large posterior capsular ruptures. In such cases the incisions are often larger, surgical time and tissue trauma are excessive, and the patient is often left aphakic. The goal of this paper is to present a modified ab externo technique designed to allow removal of the lens and placement of a ciliary sulcus sutured IOL through a small incision, with minimal trauma and shortened surgical time. Use of this technique may allow more canine patients to be emmetropic postoperatively. In addition, the ease of this procedure may encourage earlier removal of an unstable lens and decrease the risk of secondary glaucoma and retinal detachment that occur in association with lens luxation.