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犬白内障超声乳化摘除术后青光眼的发生情况:22例(1987 - 1997年)

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

作者信息

Lannek E B, Miller P E

机构信息

Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison 53706-1102, USA.

出版信息

J Am Vet Med Assoc. 2001 Jan 1;218(1):70-6. doi: 10.2460/javma.2001.218.70.

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.

摘要

目的

确定犬白内障超声乳化摘除术后发生青光眼的相关因素。

设计

回顾性研究。

动物

22只患青光眼的犬(29只眼)和21只白内障超声乳化摘除术后未患青光眼的犬(30只眼)。

方法

查阅病历。

结果

发生青光眼风险增加的眼包括波士顿梗犬的眼、术前有葡萄膜或视网膜异常的眼以及术中发生眼内出血的眼。术前晶状体诱导性葡萄膜炎的发生率、人工晶状体的存在与否或术后眼压急性升高的频率在两组之间未检测到显著差异。青光眼在术后12.8±14.1个月(中位数,10个月;范围,0.25至55个月)发生。青光眼发病后有视力恢复可能的29只眼中,有18只(62%)在青光眼确诊后平均保持视力达16.5±12.8个月(中位数,10.8个月;范围,1.5至37个月)。在研究期结束时,这些眼中大多数仍有视力。

结论及临床意义

本研究确定的风险因素将有助于对客户进行术前咨询,并完善白内障超声乳化摘除术候选者的选择标准。术后对犬的余生进行仔细随访,通过在眼压大幅升高和视力不可逆转丧失之前进行早期干预,可能会提高长期成功率。对于青光眼风险增加的犬,尤其是老年犬,白内障手术可能仍然是值得的,因为术后青光眼发病时间较长,且青光眼发生后治疗有有益效果。

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