A modifiedab externoapproach for suture fixation of an intraocular lens implant in the dog

Abstract

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.

Surgical correction of lens luxation in the horse: visual outcomes

“…An intraocular lens with a refractive power of 14D resulted in the amelioration of hyperopia in one study of pseudophakic horses [33]. It is not possible to place sulcus based IOLs in the aphakic horse eye following ICLE due the lack of commercial availability of such IOLs for the horse, although this can be done in dogs and cats to attempt to achieve emmetropia in the aphakic eye [35].…”

Update on veterinary cataract surgery

“…If the lens capsule instability prevents placement of the IOL 'in-the-bag', standard ab-interno and ab-externo approaches to suturing an IOL into the ciliary sulcus have been described in the dog [33]. In addition, a modified ab-externo technique has been described to allow the surgeon to combine small incision phacoemulsification and placement of a sutured IOL [34 ].…”

What's new in canine glaucoma?

“…Techniques to replace the lens have been refined over recent years and, in selected cases, it is now possible to suture a lens in place following routine lens-removal surgery either by phacoemulsification (Wilkie, 2008) or an open corneal approach (Stuhr, 2007) (Figs. 8a and 8b).…”