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一项关于在全身麻醉下接受预防性局部润滑的犬角膜表面疾病患病率的前瞻性研究。

A prospective study of the prevalence of corneal surface disease in dogs receiving prophylactic topical lubrication under general anesthesia.

作者信息

Dawson Charlotte, Sanchez Rick F

机构信息

The Royal Veterinary College, Department of Clinical Science and Services, Hawkshead lane, North Mymms, Herts, AL9 7TA, UK.

出版信息

Vet Ophthalmol. 2016 Mar;19(2):124-9. doi: 10.1111/vop.12272. Epub 2015 Mar 28.

Abstract

OBJECTIVE

To identify the prevalence of corneal ulceration in dogs receiving prophylactic gel lubrication under general anesthesia (GA).

MATERIALS AND METHODS

An ophthalmic examination was performed before premedication and 24 h after GA in 100 dogs (199 eyes) undergoing nonophthalmic procedures. Individuals with known pre-existing ocular surface conditions were excluded. An ocular lubricating gel containing carmellose sodium was applied by the anesthetist at induction and every 2-4 h until extubation. Logistic regression analysis was used to calculate risk factors for ulcerative disease, including signalment, length of GA, patient position, procedure performed, pre-, and post-GA ophthalmic examination findings and admitting service. A Wilcoxon rank sum test compared pre- and post-GA Schirmer tear test-1 (STT-1) values.

RESULTS

One dog (0.5% of total eyes) developed fluorescein stain uptake consistent with superficial corneal ulceration that resolved within 48 h with supportive treatment. Twenty-five (18.6% of total eyes) developed a faint, patchy corneal uptake of stain in the axial cornea that was consistent with epithelial erosion. All erosions resolved with lubrication 24 h later. The decrease in STT-1 readings at 24 h post-GA was statistically significant from those pre-GA (P < 0.001). No significant risk factors for corneal erosion/ulceration were identified.

CONCLUSIONS

The results of this study show that a basic protocol of prophylactic lubrication during GA was associated with a low prevalence of corneal ulceration but a higher prevalence of epithelial erosion. In addition, the study supports the need for post-GA corneal examination.

摘要

目的

确定在全身麻醉(GA)下接受预防性凝胶润滑的犬角膜溃疡的患病率。

材料与方法

对100只(199只眼)接受非眼科手术的犬在麻醉前及GA后24小时进行眼科检查。排除已知有眼部表面疾病的个体。麻醉师在诱导时及拔管前每2 - 4小时应用含羧甲基纤维素钠的眼部润滑凝胶。采用逻辑回归分析计算溃疡性疾病的危险因素,包括品种、GA时长、患者体位、所进行的手术、GA前后的眼科检查结果及收治科室。采用Wilcoxon秩和检验比较GA前后的泪液分泌试验-1(STT-1)值。

结果

1只犬(占总眼数的0.5%)出现与浅表角膜溃疡一致的荧光素染色摄取,经支持治疗后48小时内消退。25只犬(占总眼数的18.6%)在角膜中央出现与上皮糜烂一致的淡片状角膜染色摄取。所有糜烂在24小时后通过润滑得以消退。GA后24小时STT-1读数较GA前显著降低(P < 0.001)。未发现角膜糜烂/溃疡形成的显著危险因素。

结论

本研究结果表明,GA期间预防性润滑的基本方案与角膜溃疡的低患病率相关,但上皮糜烂的患病率较高。此外,该研究支持GA后进行角膜检查的必要性。

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