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

Abstract

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.

What's new in canine glaucoma?

“…Recent work does support our experience that the long-term prognosis in PLL is improved when the lens is removed before it luxates completely (i.e. when it is only subluxated), and that the prognosis is further improved when this is done by a small incision phaco-technique (Robinson & Sapienza, 2006;Stuhr, 2007;Manning et al, 2008). This improved outcome was shown to be attributed to a reduction in the incidence of retinal detachment following surgery, although small incision surgery and/or earlier lens removal may have an influence on the incidence of glaucoma.…”

Surgical correction of lens luxation in the horse: visual outcomes

“…The success with ICLE in dogs with lens subluxation or luxation was 72% postoperatively, but declined to 53% at one year postoperatively in one study [29]. The most common cause of postoperative blindness in the dogs was glaucoma [28].…”

“…Intracapsular lens extraction and phacoemulsification lens removal surgical procedures have both been utilized to successfully remove subluxated/luxated lenses in humans [28], dogs [29][30], and cats [31]. Surgical removal of subluxated or luxated lenses of the horse or foal is healthy, has no or controlled uveitis, the globe remains visual, can be done if the animal and the horse has the personality and temperament to tolerate aggressive postoperative topical therapy and repeat postoperative ophthalmic examinations [5].…”

Canine Secondary Glaucomas

“…80 In contrast, 70% of dogs that underwent ICLE with placement of a sutured sulcus lens in another study were visual at time of last follow-up, with 20% developing glaucoma. 76 It should be noted that most dogs in the latter study did not have increased IOP at the time of surgery and were not considered to have undergone emergency surgery; the stated goal of this study was to assess dogs that were considered good candidates for surgery. 76 This study may provide a rationale for earlier surgical intervention in dogs with lens instability.…”

“…A sutured sulcus intraocular lens may or may not be placed. 76 Medical management with antihypertensives and antiinflammatories is continued. Recently it has been proposed that ECPC at the time of lens removal may lead to better outcomes than lens removal alone.…”