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.     

Intracapsular lensectomy and sulcus intraocular lens fixation in dogs with primary lens luxation or subluxation

Objective  To evaluate the postoperative results of lensectomy and sulcus intraocular lens fixation (SIOLF) via an ab interno approach in dogs with progressive lens subluxation or early luxation.
Study design  Retrospective study.
Animals studied  Twenty eyes from 19 dogs presented to the Animal Eye Clinic for lens luxation or subluxation between 1999 and 2006.
Methods  Medical records were reviewed to evaluate preoperative lens position, vision status, intraocular pressure (IOP), and whether surgery was performed on an emergent or elective nature. Lensectomy and SIOLF were performed and postoperative status including vision, glaucoma, and retinal detachment was assessed.
Results  Average age was 8.6 years (range 4–14 years) and 55% (11/20) were terriers. Patients were followed a mean of 29.2 months (range 1–92 months) after surgery. Retinal detachment or secondary glaucoma was observed in 1 of 20 (5%) and 5 of 20 (20%) eyes, respectively, with 1 of 20 (5%) exhibiting both. Mean preoperative IOP was 16 mmHg and preoperative lens position was equally divided between luxated and subluxated lenses. Surgery was performed more frequently as an elective procedure (18/20; 90%) due to normalized IOP vs. an emergency procedure (2/20; 10%). Vision was retained in 70% (14/20) of eyes with a mean time to vision loss of 41 months in the remaining eyes due to glaucoma, retinal detachment, or retinal degeneration.
Conclusions  Complications of glaucoma and retinal detachment after SIOLF in this study were less when compared with previously reported incidence rates in the literature for lensectomy alone which may reflect improved patient selection.     

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.     

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.     

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.     

Combined transscleral diode laser cyclophotocoagulation and Ahmed gonioimplantation in dogs with primary glaucoma: 51 cases (1996-2004)

OBJECTIVE: To evaluate the combined diode laser cycloablation procedure and adjunctive Ahmed gonioimplant use in dogs with primary glaucoma. DESIGN: Retrospective study. ANIMALS: 48 dogs, 51 eyes with primary glaucoma. PROCEDURE: Medical records from two large private clinical ophthalmology services were reviewed. Signalment, duration of glaucoma, gonioscopic evaluation, laser power and duration settings, immediate postoperative and final intraocular pressure and visual results, short and long-term visual outcome, and surgical complications were recorded. RESULTS: The age range of affected dogs was 3.0-14.0 years, with a mean age of 7.5 +/- 2.6 years. Eleven pure breeds were represented, with the most common being the American Cocker Spaniel. The sex distribution was 22 neutered males, 1 intact male, 23 spayed females, and 2 intact female dogs. The right eye was affected in 33 cases, and the left eye in 18 cases. The average total joules, which was administered with the diode laser, was 109.6 +/- 23.6 J. Immediate surgical complications included fibrin formation in the anterior chamber (15), corneal ulcers (4), hyphema (7), and focal retinal detachment (1). Long-term complications included cataract formation (8 total, 2 of which were significant, vision-threatening), elevated intraocular pressure (IOP) (6), unstable gonioimplant (1), and glaucoma recurrence (14). Additional surgeries performed on the eyes over the course of study included: intrascleral prosthesis (4), enucleation (1), resection of fibrotic scar tissue (5), and repeat laser cycloablation (8). The dogs were examined for a mean follow-up time of 17.6 months (range: 2-83 months postoperatively). Twenty-nine cases were followed greater than one year. Vision was maintained in 42/51 eyes (82%) in the immediate short-term of this study. In all cases included in the study, good control of IOP was achieved in 39/51 (76%) of eyes, and IOP was poor or uncontrolled in 12/51 (24%) of eyes. Twenty out of 41 eyes (49%) maintained fair to excellent vision six months after surgery. Twelve months postoperative observations demonstrated that 12/29 (41%) of the eyes were still visual. CONCLUSIONS: In primary glaucoma, the combined procedure of laser diode cyclophotocoagulation and Ahmed valve implant was associated with return or maintenance of vision in 42/51 eyes (82%) in the immediate short-term of this study, and a long-term IOP control in 39/51 (76%) of the cases, with 12/29 eyes (41%) visual after 12 months.     

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.     

Evaluation of risk factors for development of secondary glaucoma in dogs: 156 cases (1999-2004)

OBJECTIVE: To determine the immediately antecedent cause of secondary glaucoma and the prevalence of secondary glaucoma with anterior uveitis or lens dislocation in dogs. DESIGN: Retrospective case series. ANIMALS: 156 dogs with secondary glaucoma. PROCEDURES: Cause of glaucoma was determined from records. Breed, age, sex, and neuter status of all dogs with secondary glaucoma were compared with the general hospital population. The prevalence of secondary glaucoma in dogs with a primary diagnosis of lens dislocation or anterior uveitis during the same period was determined. RESULTS: Secondary glaucoma was diagnosed in 156 of 2,257 (6.9%) dogs examined because of ophthalmic disease and was bilateral in 33 (21.2%) of those dogs. In 31 (94%) bilaterally affected dogs, the antecedent cause was the same in both eyes. Common causes of secondary glaucoma were non-surgical anterior uveitis (44.9%), anterior uveitis associated with prior phacoemulsification (15.8%), and lens dislocation (15.2%). Parson Russell Terriers, Poodles, Boston Terriers, Cocker Spaniels, Rhodesian Ridgebacks, and Australian Cattle Dogs had diagnoses of secondary glaucoma more often than expected, compared with the reference population. Age, sex, neuter status, and laterality were not associated with secondary glaucoma. The prevalence of secondary glaucoma in dogs with lens dislocation or uveitis was 15% or 17%, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Glaucoma develops secondary to many intraocular diseases, particularly uveitis and lens dislocation. Diagnosis of these diseases should prompt frequent monitoring of intraocular pressure, regardless of signalment.     

Secondary glaucomas in the dog in North America

OBJECTIVE: To determine the prevalence of secondary glaucomas in dogs associated with cataract formation, lens luxation or displacement, cataract surgery, uveitis, hyphema and intraocular neoplasia. METHODS: Information was obtained from the Veterinary Medical Data Base (VMDB) from all veterinary medical teaching hospitals in North America from March 1964 to March 2003. Secondary glaucomas were diagnosed at the same examination or after the primary diagnosis was made, and included those associated with cataract formation, lens luxation, cataract surgery, uveitis of unknown cause, hyphema of unknown cause, and intraocular neoplasia. The data were evaluated by decade, breed, gender and age of presentation. RESULTS: A total of 1 592 831 dogs were presented, and 9695 canine secondary glaucomas. Secondary glaucoma associated with cataract formation represented 81% of all the canine secondary glaucomas. Breeds (n = 7890 dogs) predisposed to secondary glaucoma and cataracts had an overall prevalence of 0.5%, but nearly 20% of all the cataractous dogs developed secondary glaucoma in at least one eye. For the years 1994-2003, these breeds included the American Cocker Spaniel; Boston Terrier; Toy, Miniature and Standard Poodle; English Springer Spaniel; Bichon Frise; and Labrador Retriever. The other forms of secondary glaucoma occurred less frequently, and included those glaucomas with lens luxation or displacement (779 dogs; 12.0%), postcataract surgery (528 dogs; 5.1%), with uveitis from unknown cause (399 dogs; 7.1%), with hyphema from unknown cause (117 dogs; 7.3%), and with intraocular neoplasia (19 dogs; 3.5%). The risk of the secondary glaucomas from 1984 to 2002 was highest after the intracapsular lens extraction (ICLE), less in the extracapsular technique (ECLE), and lowest for the phacoemulsification/phacofragmentation method. CONCLUSION: Prevalence of the canine secondary glaucomas ranges from 0.25% (1964-1973), 0.46% (1974-1983), 0.79% (1984-1993), to 0.80% (1994-2003) and are as frequent as the primary or breed-related glaucomas during these same time periods.     

The use of transscleral cyclophotocoagulation with a diode laser for the treatment of glaucoma occurring post intracapsular extraction of displaced lenses: a retrospective study of 15 dogs (1995-2000)

The objective of this retrospective study was to evaluate transscleral cyclophotocoagulation (TSCP) using a diode laser for treating aphakic glaucoma that developed after intracapsular lens extraction (ICLE) had been performed for displaced lenses. Records of 15 dogs (21 eyes) were reviewed. The intraocular pressure (IOP) and the presence of vision were recorded at the time of ICLE and TSCP and at 1, 3, 6-9, 12 and 24 months post TSCP. The glaucoma was considered controlled if the IOP was less than 25 mmHg. The results indicated that the effectiveness of TSCP using a diode laser for treating aphakic glaucoma was of a short-term duration (1-3 months), with three patients needing repeat TSPC. In addition, adjunctive antiglaucoma medications were often required to maintain an adequately controlled IOP. Over the 24-month period the number of dogs requiring intrascleral prosthesis, intraocular gentamicin or enucleation, or that were lost to follow-up, increased.     

Phacoemulsification and acryl foldable intraocular lens implantation in dogs: 32 cases

This study evaluated the surgical outcome and complications of phacoemulsification and the implantation of an acryl foldable intraocular lens (IOL) with a squared edge in dogs with cataracts. Thirty-two eyes from 26 dogs were examined. The mean follow up period was 75.9 days ranging from 23 to 226 days. The complications after phacoemulsification were posterior capsular opacity (PCO) around the IOL (n = 11), ocular hypertension (n = 4), focal posterior synechia (n = 4), hyphema (n = 3) and corneal ulcer (n = 2). The complications associated with the IOL were decenteration of the optic (n = 2) and ventral haptic displacement (n = 1). Most cases of PCO were found only around the margin of the IOL, and all eyes had vision during the observation period. In conclusion, the implantation of an acryl-foldable lens with a squared edge at the time of phacoemulsification is an effective method for preserving the central visual field of dogs with cataract.     

The effect of a topical antioxidant formulation including N-acetyl carnosine on canine cataract: a preliminary study

OBJECTIVE: To determine the efficacy of a topical antioxidant formulation including N-acetyl carnosine in the treatment of canine cataract in a preliminary nonplacebo, controlled, unmasked study. ANIMALS STUDIED: Thirty dogs of varying breeds and ages with a spectrum of lens opacities ranging from nuclear sclerosis to total mature cataract. METHODS: Dogs were treated three times daily with topical 2% N-acetyl carnosine in a buffered vehicle containing the antioxidants glutathione, cysteine ascorbate, L-taurine and riboflavin (Ocluvet, Practivet, Phoenix, AZ, USA). Dogs were examined prior to treatment and at 2, 4 and 8 weeks during treatment, by direct and indirect ophthalmoscopy and slit-lamp biomicroscopy after pharmacologic pupil dilation. Photographic documentation of lens opacity was achieved by retroillumination photography, with three photographs taken at each examination time-point. A lens opacification index (LOI), determined by integration of the grayscale level of each pixel across the image, was evaluated by computerized image analysis of digitized images. Alteration in mean LOI was determined for each animal, having normalized the initial LOI. RESULTS: Fifty-eight eyes of 30 dogs were evaluated, 22 with mature cataract, 13 with immature cataract, 9 with cataract associated with other intraocular disease such as uveitis and 14 with nuclear sclerosis alone. One dog was unilaterally anophthalmic after previous enucleation and one had a phthytic eye after previous uveitis-induced glaucoma. Image analysis showed a reduction in mean LOI in all cataract groups (mean resolution in opacity of 2.3 +/- 0.33% for all cataracts), although this was only statistically significant in those eyes with immature cataract (mean resolution of opacity 4.5 +/- 0.33%) or nuclear sclerosis (mean decrease in opacity 5 +/- 0.37%). Reduction in lens opacity was seen in eyes with mature cataract (0.5 +/- 0.4%) and in miscellaneous cataract associated with intraocular inflammation (1.3 +/- 0.4%), but these changes were not statistically significant. Owner evaluation of visual capability, however, suggested improvement in vision in 80% of cases by the end of the study. CONCLUSIONS: This study demonstrates some marginal reduction in lens opacification in a substantial number of cases of canine cataract with the use of a topical nutritional antioxidant formulation including N-acetyl carnosine. Lens opacification was improved with treatment in eyes with immature cataract or nuclear sclerosis while in eyes with mature cataract or cataract with associated intraocular inflammatory pathology less reduction was seen.     

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.     

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.     

Long-term complications after phacoemulsification for cataract removal in dogs: 172 cases (1995-2002)

OBJECTIVE: To determine common postoperative complications and risk factors for development of postoperative glaucoma or failure to preserve vision after phacoemulsification for cataract removal in dogs. Design-Retrospective case series. ANIMALS: 172 dogs (290 eyes) that underwent phacoemulsification surgery for cataract removal. PROCEDURE: Medical records were reviewed for postoperative complications; prevalence rates for each complication were calculated for follow-up periods of 3 months, > 3 to 6 months, > 6 months to 1 year, > 1 to 2 years, > 2 to 3 years, > 3 to 4 years, and > 4 years. Odds ratios for breed, age, sex, cataract hypermaturity, lens-induced uveitis, and diabetes mellitus were determined with respect to glaucoma and failure (ie, blindness, enucleation, or evisceration). RESULTS: The most common complication was mild posterior capsule opacification. Retinal detachment was uncommon (1% to 2%) for all time periods. Prevalence of glaucoma increased with time, although it remained < 10% until after the 1-year follow-up period. Boston Terriers, Cocker Spaniels, Cocker Spaniel-Poodle crosses, and Shih Tzus had increased risk of developing glaucoma. Eyes with hypermature cataracts were more likely to develop glaucoma. Prevalence of failure increased with time, although it remained < 10% until after the 3-year follow-up period. Cocker Spaniel-Poodle cross and Shih Tzus were more likely to have failure. CONCLUSIONS AND CLINICAL RELEVANCE: Evaluation of breed and cataract hypermaturity may aid in the selection of patients. The increasing prevalence of postoperative complications with time indicated that longterm monitoring is warranted.     

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.     

The Treatment of Acute Glaucoma in Dogs and Cats

Objective: Glaucoma is an optic nerve disease that may result in rapid loss of vision. Early detection of acute glaucoma and aggressive treatment is important to preserve vision. Continued treatment is indicated in chronic glaucoma to alleviate discomfort associated with chronic elevated intraocular pressure.
Etiology: In primary glaucoma, an abnormal iridocorneal angle results in obstruction to outflow of aqueous humor. In secondary glaucoma, an otherwise normal iridocorneal angle is obstructed by abnormalities such as a luxated lens, neovascular membranes or inflammatory material.
Diagnosis: The diagnosis is made by a combination of clinical signs such as corneal edema, mydriasis, decreased vision, episcleral hyperemia, and confirmed by measuring an elevation in intraocular pressure. Complete ophthalmic examination, knowledge of breed predisposition to various ocular diseases and gonioscopy will aid in distinguishing between primary and secondary glaucoma
Therapy: Aggressive medical management is important in acute glaucoma. Surgical procedures are often indicated after initial emergency medical treatment of acute glaucoma. Chronic, painful blind eyes are best treated with one of various surgical procedures.
Prognosis: The prognosis for maintaining vision or regaining temporarily lost vision in acute glaucoma is related to numerous factors including time between onset of clinical signs and appropriate treatment, etiology of the glaucoma, initial response to therapy and client compliance.     

The incidence of posterior capsule disruption during phacoemulsification and associated postoperative complication rates in dogs: 244 eyes (1995-2002)

OBJECTIVE: The objective of this retrospective study was to report the incidence of posterior capsule disruption during routine phacoemulsification and to document the postoperative outcomes and complications in eyes with posterior capsule disruption compared with eyes with intact posterior capsules. PROCEDURES: Records of 143 dogs (244 eyes) were reviewed. Data collected included whether the posterior capsule was disrupted, whether the disruption was planned or accidental, whether an intraocular lens was implanted, and visual outcome. Records were reviewed for postoperative complications. Intraocular lens implantation rates, complication rates, and visual outcomes were compared between intact and disrupted posterior capsule groups using Chi-square analyses. RESULTS: The posterior capsule was disrupted in 33/244 eyes (14%). Planned capsulotomies accounted for 36% of the disruptions. Intraocular lenses were implanted in 76% of eyes without a disruption of the posterior capsule and in 31% of eyes with a posterior capsule disruption. Intraocular lenses were more likely to be implanted in eyes with a planned disruption of the posterior capsule (7/12; 58%) than in eyes with an accidental disruption (3/20; 15%). There were no significant differences in postoperative complications or visual outcome between eyes with posterior capsule disruption and those without. CONCLUSIONS: The most significant complication of posterior capsule disruption during phacoemulsification is the inability to implant an intraocular lens. Intraocular lenses are more likely to be placed in eyes with intentional disruptions of the posterior capsule than those with accidental ruptures.     

Cullen frontal sinus valved glaucoma shunt: preliminary findings in dogs with primary glaucoma

PURPOSE: To evaluate the efficacy of a novel, professionally manufactured, frontal sinus valved glaucoma shunt in maintaining normal intraocular pressure (IOP) and vision in dogs with primary glaucoma. METHODS: Three eyes of three dogs diagnosed with primary glaucoma were included in this prospective clinical study. A Cullen frontal sinus valved glaucoma shunt was implanted into each glaucomatous globe. Dogs were treated postoperatively with topical neomycin/polymyxin B/0.1% dexamethasone and 0.03% flurbiprofen every 6 h tapered over 8-12 weeks, and meloxicam at 0.1 mg/kg orally every 24 h for 7-10 days. IOP, intracameral shunt position and apparent patency, and vision were assessed twice daily for up to 4 (n= 3 eyes) and 10 (n= 2 eyes) days postoperatively, and then at re-examination periods of up to 36 weeks (n= 1 eye). Postoperative complications were recorded and documented photographically. RESULTS: Normal IOP was maintained in all shunted globes (range 10-29 mmHg; mean = 16.7 mmHg at 24 h; IOP = 23 mmHg at 36 weeks) postoperatively for 2 days (3/3 eyes), 8 weeks (2/2 eyes), and 36 weeks (1/1 eye) without additional antiglaucoma therapies. Photopic vision and shunt position and patency were maintained in all shunted globes for all follow-up periods. Postoperative complications included mild aqueous flare and fibrin (n= 3 eyes for 3-10 days postoperatively); intracameral shunt occlusion with fibrin (n= 1 eye at days 2 and 4); partial anterior chamber tube extrusion (n= 1 eye at day 4), and focal corneal edema (n= 1 eye at 18 weeks). Tissue plasminogen activator injected intracamerally through the silicone tube near the frontal sinus effectively resolved the fibrinous shunt occlusion. CONCLUSIONS: The Cullen frontal sinus valved glaucoma shunt shows promise for the management of canine primary glaucoma.     

大熊猫白内障手术临床研究

目的探讨大熊猫白内障摘除合并人工晶体植入手术技术。结果发现大熊猫白内障的晶体核硬度大,超声乳化吸除有困难;由于人与大熊猫眼球解剖结构有差异,人用人工晶体不适合大熊猫。结论需要对较大量的大熊猫进行无创性眼球检测,了解其眼睛的屈光状态和晶状体的屈光度,才能为研制大熊猫专用的人工晶体提供科学的依据。