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Effects of one-week versus one-day preoperative treatment with topical 1% prednisolone acetate in dogs undergoing phacoemulsification

Nancy J. McLeanDepartment of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996.

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Daniel A. WardDepartment of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996.

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Diane V. H. HendrixDepartment of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996.

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Rachel K. VaughnDepartment of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996.

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Abstract

Objective—To compare the effects of 2 preoperative anti-inflammatory regimens on intraocular inflammation following phacoemulsification.

Design—Randomized controlled trial

Animals—21 dogs with immature cataracts.

Procedures—All dogs had cataract surgery via phacoemulsification, and most received prosthetic intraocular lenses. Dogs were randomly divided into 2 groups. Group A dogs were treated topically with prednisolone acetate for 7 days prior to surgery, whereas prednisolone acetate treatment commenced the evening prior to surgery in group B dogs. Postoperative care was identical for both groups. Blood-aqueous barrier breakdown was quantified by use of anterior chamber fluorophotometry, with fluorescein entry into the anterior chamber measured 2 and 9 days after surgery compared with baseline scans obtained prior to surgery. Ophthalmic examinations were performed before surgery and 1 day, 9 days, 3 weeks, 7 weeks, 3 months, and 6 months after surgery. A subjective inflammation score was established at each examination. Intraocular pressures were measured 4 and 8 hours after surgery and at each follow-up examination.

Results—There was no difference in the extent of blood-aqueous barrier disruption between the groups at 2 or 9 days after surgery. Subjective inflammation scores were also similar at most time points. Dogs in group A developed postoperative ocular hypertension at a higher frequency (60%) than did those in group B (18%).

Conclusions and Clinical Relevance—In dogs that underwent cataract surgery via phacoemulsification, a full week of topical prednisolone acetate treatment prior to surgery did not decrease postoperative inflammation, compared with commencement of topical prednisolone acetate treatment the evening prior to surgery, and was associated with a greater incidence of postoperative ocular hypertension.

Abstract

Objective—To compare the effects of 2 preoperative anti-inflammatory regimens on intraocular inflammation following phacoemulsification.

Design—Randomized controlled trial

Animals—21 dogs with immature cataracts.

Procedures—All dogs had cataract surgery via phacoemulsification, and most received prosthetic intraocular lenses. Dogs were randomly divided into 2 groups. Group A dogs were treated topically with prednisolone acetate for 7 days prior to surgery, whereas prednisolone acetate treatment commenced the evening prior to surgery in group B dogs. Postoperative care was identical for both groups. Blood-aqueous barrier breakdown was quantified by use of anterior chamber fluorophotometry, with fluorescein entry into the anterior chamber measured 2 and 9 days after surgery compared with baseline scans obtained prior to surgery. Ophthalmic examinations were performed before surgery and 1 day, 9 days, 3 weeks, 7 weeks, 3 months, and 6 months after surgery. A subjective inflammation score was established at each examination. Intraocular pressures were measured 4 and 8 hours after surgery and at each follow-up examination.

Results—There was no difference in the extent of blood-aqueous barrier disruption between the groups at 2 or 9 days after surgery. Subjective inflammation scores were also similar at most time points. Dogs in group A developed postoperative ocular hypertension at a higher frequency (60%) than did those in group B (18%).

Conclusions and Clinical Relevance—In dogs that underwent cataract surgery via phacoemulsification, a full week of topical prednisolone acetate treatment prior to surgery did not decrease postoperative inflammation, compared with commencement of topical prednisolone acetate treatment the evening prior to surgery, and was associated with a greater incidence of postoperative ocular hypertension.

Contributor Notes

Dr. McLean's present address is VCA Veterinary Care Animal Hospital and Referral Center, 9901 Montgomery Blvd, Albuquerque, NM 87111.

Dr. Vaughn's present address is Pittsburgh Veterinary Specialty and Emergency Center, 807 Camp Horne Rd, Pittsburgh, PA 15237.

Supported by the American College of Veterinary Ophthalmologists Vision for Animals Foundation and the University of Tennessee Companion Animal Fund.

Address correspondence to Dr. Ward (dward@utk.edu).