Development of glaucoma after phacoemulsification for removal of cataracts in dogs: 22 cases (1987–1997)

Eva B. Lannek Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706-1102.

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Dr. Paul E. Miller

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 DVM, DACVO

Abstract

Objective—To determine factors contributing to glaucoma after lens extraction via phacoemulsification in dogs.

Design—Retrospective study.

Animals—22 dogs (29 eyes) with glaucoma and 21 dogs (30 eyes) without glaucoma after phacoemulsification.

Procedure—Medical record review.

Results—Eyes at increased risk for glaucoma included those of Boston Terriers, those with uveal or retinal abnormalities before surgery, and those with intraoperative intraocular hemorrhage. Significant differences between groups were not detected for incidence of preoperative lens-induced uveitis, presence of an intraocular lens, or frequency of an acute postoperative increase in intraocular pressure. Glaucoma developed (mean ± SD) 12.8 ± 14.1 months (median, 10 months; range, 0.25 to 55 months) after surgery.Eighteen of 29 (62%) eyes with potential for vision after onset of glaucoma retained vision for a mean of 16.5 ± 12.8 months (median, 10.8 months; range, 1.5 to 37 months) after glaucoma was diagnosed. Most of these eyes still had vision at the conclusion of the study period.

Conclusions and Clinical Relevance—Risk factors identified by this study will aid in preoperative counseling of clients and refining selection criteria for candidates for phacoemulsification. Careful follow-up for the remainder of the dog's life after surgery may improve long-term success rates by permitting early intervention before intraocular pressure increases substantially and vision is irreversibly lost. Surgery for cataracts may still be worthwhile in dogs with increased risk of glaucoma, especially if elderly, because of the lengthy period to onset of glaucoma after surgery and the beneficial effects of treatment after glaucoma develops. ( J Am Vet Med Assoc 2001; 218:70–76)

Abstract

Objective—To determine factors contributing to glaucoma after lens extraction via phacoemulsification in dogs.

Design—Retrospective study.

Animals—22 dogs (29 eyes) with glaucoma and 21 dogs (30 eyes) without glaucoma after phacoemulsification.

Procedure—Medical record review.

Results—Eyes at increased risk for glaucoma included those of Boston Terriers, those with uveal or retinal abnormalities before surgery, and those with intraoperative intraocular hemorrhage. Significant differences between groups were not detected for incidence of preoperative lens-induced uveitis, presence of an intraocular lens, or frequency of an acute postoperative increase in intraocular pressure. Glaucoma developed (mean ± SD) 12.8 ± 14.1 months (median, 10 months; range, 0.25 to 55 months) after surgery.Eighteen of 29 (62%) eyes with potential for vision after onset of glaucoma retained vision for a mean of 16.5 ± 12.8 months (median, 10.8 months; range, 1.5 to 37 months) after glaucoma was diagnosed. Most of these eyes still had vision at the conclusion of the study period.

Conclusions and Clinical Relevance—Risk factors identified by this study will aid in preoperative counseling of clients and refining selection criteria for candidates for phacoemulsification. Careful follow-up for the remainder of the dog's life after surgery may improve long-term success rates by permitting early intervention before intraocular pressure increases substantially and vision is irreversibly lost. Surgery for cataracts may still be worthwhile in dogs with increased risk of glaucoma, especially if elderly, because of the lengthy period to onset of glaucoma after surgery and the beneficial effects of treatment after glaucoma develops. ( J Am Vet Med Assoc 2001; 218:70–76)

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