The primary goal of phacoemulsification is restoration or preservation of vision. Medical records for 103 dogs (179 eyes) that had undergone phacoemulsification with or without intraocular lens (IOL) replacement were reviewed. Presurgical evaluation included measurement of intraocular pressure, electroretinogram, and ocular ultrasound. Dogs with uveitis were treated and surgery was delayed until it was controlled; in dogs at higher risk for retinal detachment, retinopexy was performed before surgery. Dogs were pretreated with topical neomycin polymyxin dexamethasone (NPD) and an NSAID 3 days before surgery. IOLs were placed unless there was a contraindication for their use. Treatment with NSAIDs continued postoperatively for 2 weeks in most cases, and topical NPD continued for 2 to 6 months.
The most common postoperative complications were postoperative ocular hypertension (22.9%), corneal lipidosis (19.0%), uveitis (16.2%), intraocular hemorrhage (IOH, 12.3%), retinal detachment (8.4%), and glaucoma (6.7%). The majority of eyes were functionally visual (82.7%). Reduced vision was recorded in 13 eyes and blindness occurred in 18 eyes. Postoperative IOH was a significant risk factor for blindness. Boston terriers and poodles were more likely to have IOH when compared with mixed-breed dogs.
Commentary: Not all dogs with cataracts can be treated surgically, but phacoemulsification can certainly bring a new quality of life for both dog and owner. When surgery is considered, this article is a nice review of some of the complications that clinicians should be aware of but also affirms that phacoemulsification and implantation of foldable acrylic IOLs have a good prognosis for vision.—Patricia Thomblison, DVM, MS
Postoperative complications and visual outcomes of phacoemulsification in 103 dogs (179 eyes): 2006–2008. Klein HE, Krohne SG, Moore GE, Stiles J. VET OPHTHALMOL 14:114-120, 2011.