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

Abstract

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.

Retrospective investigation of perioperative risk factors for immediate postoperative corneal erosions in dogs undergoing phacoemulsification

“…Total intraocular fluid volume was not specifically reported in the medical records of our population but has been correlated with endothelial cell loss, 88,89 increased central corneal thickness immediately postoperatively in dogs, 12 and recently with the eventual development of corneal ulcerations in a canine study 6 . Postoperative stromal and subepithelial edema may compromise the health and integrity of the corneal epithelium and represent factors that could predispose to IPCE.…”

“…Both values are normalized, accounting for different phacoemulsification settings between patients; 82 and CDE is a value adjusted for longitudinal and torsional ultrasound delivered by modern phacoemulsification handpieces, a value now reported at surgery completion by many machines. A recent veterinary study found increased CDE to be predictive of glaucoma and vision loss in dogs undergoing routine phacoemulsification 6 …”

“…A recent veterinary study found increased CDE to be predictive of glaucoma and vision loss in dogs undergoing routine phacoemulsification. 6 In our cohort, the default phacoemulsification mode delivered by our machine was continuous torsional ultrasound. Therefore, APT was used as the normalized value calculated by multiplying the PT and average PP.…”

“…Surgical removal is the only definitive treatment for cataracts in humans and dogs, and a modern approach using phacoemulsification is the recommended technique in both species 4 . Cumulatively, studies evaluating phacoemulsification in dogs report positive clinical outcomes in 70–95% of operated eyes 5–10 . Despite favorable success rates and technological advances in canine cataract surgery, short‐ and long‐term intraocular complications are described.…”

“…4 Cumulatively, studies evaluating phacoemulsification in dogs report positive clinical outcomes in 70-95% of operated eyes. [5][6][7][8][9][10] Despite favorable success rates and technological advances in canine cataract surgery, short-and long-term intraocular complications are described. In canine eyes, postoperative ocular hypertension (POH), glaucoma, persistent uveitis, and retinal detachment are the most common and most visionthreatening complications described.…”