Wilkie D A, Gemensky-Metzler A J, Colitz C M H, Bras I D, Kuonen V J, Norris K N, Basham C R
The Ohio State University, College of Veterinary Medicine, Department of Veterinary Clinical Sciences, 601 Vernon L. Tharp St., Columbus, OH 43210, USA.
Vet Ophthalmol. 2006 Sep-Oct;9(5):328-34. doi: 10.1111/j.1463-5224.2006.00490.x.
To describe the clinical presentation and surgical outcome of diabetic canine patients with cataracts and preoperative spontaneous lens capsule rupture.
A total of 20 dogs and 40 eyes were included in the retrospective evaluation. The patients' ages ranged from 5 to 14 years (mean 8.5 years).
All dogs had clinical diabetes mellitus, with the duration since diagnosis ranging from 30 to 240 days (mean 123 days). Cataracts were bilateral and noted to have been present for 14-112 days (mean 39 days). Of the 40 eyes affected with cataracts, 30 had a spontaneous rupture of the lens capsule prior to surgery. The capsular rupture was diagnosed on clinical examination in 28/30 eyes and was noted intraoperatively in 2/30. The location of the capsular rupture was equatorial in 29/30 and posterior in 1/30 eyes. Surgery was performed in 38/40 eyes, with one case lost to follow-up without surgical intervention. Prior to surgery, routine diagnostic ophthalmic examination, ocular ultrasound, electroretinography, and systemic evaluation were performed in all dogs. Surgical procedures included phacoemulsification in 28/40 eyes, with IOL placement performed in 20/28 eyes. Intrascleral prosthesis placement or enucleation was performed in 8/40 and 2/40 eyes, respectively, due to a significantly reduced ERG or secondary glaucoma.
The duration of clinical follow-up (19/20 dogs) ranged from 1 to 36 months (mean 12.9 months). All eyes that had cataract surgery with or without IOL placement were sighted at the time of the last follow-up examination. Spontaneous lens capsule rupture associated with diabetes mellitus, cataract and rapid lens intumescence occurs in the dog. Early surgical intervention, prior to secondary complications of glaucoma and loss of retinal function, is associated with a favorable outcome.
描述患有白内障且术前晶状体囊自发破裂的糖尿病犬的临床表现及手术结果。
共有20只犬40只眼纳入回顾性评估。这些犬的年龄在5至14岁之间(平均8.5岁)。
所有犬均患有临床糖尿病,自诊断以来的病程为30至240天(平均123天)。白内障为双侧性,已存在14至112天(平均39天)。在40只受白内障影响的眼中,30只在手术前发生了晶状体囊的自发破裂。28/30只眼通过临床检查诊断出囊破裂,2/30只眼在术中发现。囊破裂的位置在29/30只眼中位于赤道部,1/30只眼中位于后部。40只眼中的38只接受了手术,1例未进行手术干预而失访。所有犬在手术前均进行了常规眼科诊断检查、眼部超声检查、视网膜电图检查和全身评估。手术方式包括40只眼中的28只进行了超声乳化术,其中28只中的20只植入了人工晶状体。由于视网膜电图明显降低或继发性青光眼,分别有8/40只眼和2/40只眼进行了巩膜内假体植入或眼球摘除术。
临床随访时间(19/20只犬)为1至36个月(平均12.9个月)。所有接受白内障手术(无论是否植入人工晶状体)后的眼在最后一次随访检查时均有视力。糖尿病、白内障和晶状体快速肿胀相关的晶状体囊自发破裂在犬中出现。在青光眼和视网膜功能丧失等继发性并发症出现之前进行早期手术干预,预后良好。