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一匹鞍马驹的超声乳化白内障吸除术及 +14 屈光度人工晶状体植入术

Phacoemulsification and +14 diopter intraocular lens placement in a Saddlebred foal.

作者信息

Harrington Jay T, McMullen Richard J, Clode Alison B, Gilger Brian C

机构信息

Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA.

出版信息

Vet Ophthalmol. 2013 Mar;16(2):140-8. doi: 10.1111/j.1463-5224.2012.01032.x. Epub 2012 May 29.

DOI:10.1111/j.1463-5224.2012.01032.x
PMID:22640484
Abstract

A 2-month-old, 110-kg Saddlebred filly presented for evaluation of bilateral cataracts. A hypermature cataract in the left eye (OS) and an incipient nuclear cataract in the right eye (OD) were diagnosed. Electroretinography and ocular ultrasound revealed no contraindications for surgical removal of the cataractous lens OS. Phacoemulsification and implantation of a +14 diopter (D) intraocular lens (IOL) OS were performed at 4 months of age without complication, with the exception of a partial iridectomy performed on a small iris section that prolapsed through the corneal incision. Complete ophthalmic examinations, including ocular ultrasound and streak retinoscopy, were performed 1, 2, 6 weeks, 4 months, 1, and 2 years postoperatively. Diffuse corneal edema and a superficial corneal ulcer developed OS during the early postoperative period and resolved without complication. Dyscoria was identified owing to anterior synechia of the dorsomedial iris at the incision site. Two years after surgery, menace response, palpebral reflex, dazzle reflex, and pupillary light reflexes were present in both eyes (OU). The IOL remained centrally positioned within the capsule, with mild anterior tilting of the superior portion of the IOL and mild fibrosis of the lens capsule. The postoperative net refractive error was +0.31 D OS. Based on this report, a +14 D IOL may be the appropriate choice following lens extraction in a foal to achieve refraction near emmetropia at maturity. To our knowledge, this is the first report of phacoemulsification and IOL implantation in a foal with long-term follow-up.

摘要

一匹2月龄、体重110千克的鞍马品种小母马因双侧白内障前来评估。诊断发现左眼(OS)为过熟期白内障,右眼(OD)为早期核性白内障。视网膜电图和眼部超声检查显示,手术摘除左眼白内障晶状体无禁忌证。该马在4月龄时接受了左眼白内障超声乳化吸除术并植入了+14屈光度(D)的人工晶状体(IOL),手术过程顺利,仅在一小部分虹膜经角膜切口脱出时进行了部分虹膜切除术。术后1周、2周、6周、4个月、1年和2年进行了包括眼部超声和带状检影法在内的全面眼科检查。术后早期左眼出现弥漫性角膜水肿和浅表性角膜溃疡,但均未发生并发症而自行消退。因切口部位虹膜背内侧发生前粘连而出现瞳孔变形。术后两年,双眼(OU)均有威胁反应、眼睑反射、强光反射和瞳孔对光反射。人工晶状体仍位于囊袋中央,人工晶状体上半部分有轻度前倾,晶状体囊膜有轻度纤维化。术后左眼净屈光不正为+0.31D。根据本报告,+14D的人工晶状体可能是马驹晶状体摘除术后的合适选择,以使其成年时屈光接近正视。据我们所知,这是第一例对马驹进行白内障超声乳化吸除术及人工晶状体植入并长期随访的报告。

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