Intraoperative findings and postoperative results associated with cataract surgery performed after retinal reattachment surgery in dogs-36 cases (41 eyes).

OBJECTIVE: To report intraoperative findings and complications associated with cataract surgery performed after retinal reattachment surgery (RR) via pars plana vitrectomy (PPV) using perfluoro-n-octane (PFO), laser retinopexy, and silicone oil tamponade in dogs. ANIMALS STUDIED: Retrospective record review of dogs that underwent post-RR cataract surgery. Signalment, time between RR and cataract surgery, type of lens extraction, postoperative visual status, and intra- and postoperative complications were recorded. Cataract formation or progression after RR was categorized as early (≤12 months) or late (>12 months). RESULTS: A total of 36 dogs (41 eyes) were included. Average time between RR and cataract surgery was 665 days (median: 546). Early postoperative incidence of cataracts occurred in 19 eyes (46.3%). Types of lens extraction included phacoemulsification with intraocular lens (86.1%, 31/36 dogs), phacoemulsification alone (11.1%, 4/36 dogs), and intracapsular lens extraction (2.8%, 1/36 dogs). Visual improvement occurred in 95.1% of eyes (39/41) immediately postoperatively. Long term, 93.9% of eyes (31/33) maintained vision at 1 month, 85.2% of eyes (23/27) at 3 months, 77.3% of eyes (17/22) at 6 months, and 60% (12/20) at 12 months postoperatively. The most common postoperative complications were glaucoma (29.3%, 12/41 eyes), corneal ulceration (24.4%, 10/36 eyes), fibrin formation (21.9%, 9/41 eyes), and silicone oil migration into the anterior chamber (19.5%, 8/41 eyes). CONCLUSION: Post-RR cataract surgery should be considered in dogs with vision loss from cataracts after RR. In most eyes, vision was maintained up to 1 year postoperatively.

Effect of immediate postoperative intracameral tissue plasminogen activator (tPA) on anterior chamber fibrin formation in dogs undergoing phacoemulsification.

OBJECTIVE: To evaluate the postoperative effect of intracameral tPA (alteplase; Activase®, Genentech, San Francisco, CA), administered at immediate conclusion of phacoemulsification, on anterior chamber fibrin formation in dogs. PROCEDURES: Forty-one dogs (82 eyes) undergoing bilateral phacoemulsification received 25 µg/0.1 mL intracameral tPA in one eye and 0.1 mL unmedicated aqueous vehicle in the contralateral eye immediately after corneal incision closure. Intraocular pressure (IOP) was measured, and severity of anterior chamber fibrin formation, aqueous flare, pigment precipitates on the intraocular lens (IOL) implant, posterior capsular opacification (PCO), and corneal edema were graded at approximately 1 week, 2-3 weeks, 4-6 weeks, 8-12 weeks, and greater than 3 months postoperatively. RESULTS: Anterior chamber fibrin developed postoperatively in 68.3% of dogs (28/41) and 50% of eyes (41/82). In tPA-treated eyes, 53.7% (22/41) developed fibrin compared to 46.3% of control eyes (19/41). Some degree of postoperative ocular hypertension (POH) occurred in 53.7% of dogs (22/41) and 36.5% of eyes (30/82). In tPA-treated eyes, 34.1% (14/41) experienced POH compared to 39% of control eyes (16/41). Additional intracameral tPA injection was later required in 29.3% of both tPA-treated (12/41) and control eyes (12/41). CONCLUSIONS: Administration of intracameral tPA at immediate conclusion of canine phacoemulsification had no clinically observable effect on anterior chamber fibrin incidence at any time point. tPA-treated eyes showed no prophylaxis against POH or secondary glaucoma compared to control eyes and received late postoperative tPA injections at the same frequency as control eyes.

Porcine urinary bladder extracellular matrix grafts (ACell Vet® Corneal Discs) for keratomalacia in 17 equids (2012-2013).

OBJECTIVE: To describe the clinical course, outcomes, and complications associated with use of commercially available porcine urinary bladder extracellular matrix (ECM) grafts (ACell Vet(®) Corneal Discs) in equid patients with keratomalacia, and to evaluate the efficacy of ECM grafts as a viable alternative to other biomaterials for corneal grafting in equid patients. ANIMALS: Sixteen horses and one donkey (17 eyes) with unilateral keratomalacia severe enough to warrant surgical repair between August 2012 and September 2013. PROCEDURE: Retrospective medical record review to identify equid patients meeting inclusion criteria of (i) diagnosis with keratomalacia severe enough to warrant surgical repair and (ii) surgical repair with an extracellular matrix graft. RESULTS: Eleven geldings, four mares, and two colts met inclusion criteria. Patients averaged 9 years of age. Twelve of 17 eyes (71%) were considered infected based on either corneal cytology (10/17, or 59%) or corneal culture (12/17, or 71%) positive for bacteria (8/17, or 47%) or fungi (9/17, or 53%). At the time topical medications were discontinued, 16 eyes (94%) were visual. One operated eye ruptured 5 days postoperatively and was enucleated. Keratouveitis developed in 14/14 eyes that underwent regular examinations approximately 2 weeks postoperatively which responded to systemic nonsteroidal anti-inflammatory drug therapy. CONCLUSIONS: Extracellular matrix grafts may be a viable alternative to other biomaterials for corneal grafting in equids. Advantages include commercial availability and shelf storage.