Centre Hospitalier Vétérinaire AniCura Aquivet, Eysines, France.
Open Vet J. 2023 Aug;13(8):977-982. doi: 10.5455/OVJ.2023.v13.i8.3. Epub 2023 Aug 31.
Posterior capsular opacification (PCO) is a cause of decreased vision after canine cataract surgery. PCO can appear in the months following surgery but can also be present at the time of surgery.
To describe the intraoperative management of marked axial PCO during canine cataract surgery through a retrospective case series study of six cases.
Six dogs (six eyes) with cataracts were included in this study. A complete ophthalmologic examination including electroretinography and ocular ultrasound was performed. After conventional phacoemulsification, a marked PCO obstructing the visual axis was found in five cases, previously diagnosed by ultrasound in the sixth. An axial posterior capsulorhexis (APC) was performed in all cases, before or after implantation of the intraocular lens (IOL). For the four cases implanted before APC, the posterior capsule (PC) was visualized either by positioning the IOL laterally in the bag with viscoelastic or through the optic of the implant. After perforation of the PC with a 30-Gauge needle, APC was initiated with Vannas curved scissors, then finalized with Utrata forceps to obtain a circular axial opening (3 mm diameter). In each case, a moderate anterior vitrectomy was performed through the APC (under the IOL when initially placed), then the IOL centered and the viscoelastic was removed.
Six dogs (Beagle, German Shepherd, Cavalier King Carles, French pointing dog, American bully, Beagle Harrier) aged 11 to 94 months (mean 51.8) were included. The mean follow-up period was 15.5 months (range 10-22). Visual function with capsular axial transparency and well-centered IOL, without complications during the follow-up period, was preserved for each eye.
APC combined with moderate anterior vitrectomy appears to be effective in the treatment of marked axial PCO obstructing the visual axis during canine cataract surgery.
后囊混浊(PCO)是犬白内障手术后视力下降的一个原因。PCO 可在手术后数月出现,但也可在手术时出现。
通过对 6 例犬白内障手术中明显轴向 PCO 的回顾性病例系列研究,描述其术中处理方法。
本研究纳入了 6 只(6 只眼)患有白内障的犬。进行了全面的眼科检查,包括视网膜电图和眼部超声检查。在常规超声乳化后,发现 5 例病例存在明显的阻碍视轴的 PCO,第 6 例病例在术前超声检查中已被诊断出。在所有病例中,均进行了轴向后囊切开术(APC),在植入人工晶状体(IOL)之前或之后进行。对于在 APC 之前植入的 4 例病例,通过将 IOL 侧向定位在囊袋中用粘弹性物质或通过植入物的光学系统来观察后囊。用 30-Gauge 针头穿透后囊后,用 Vannas 弯剪开始进行 APC,然后用 Utrata 镊子完成,以获得圆形轴向开口(直径 3 毫米)。在每例病例中,通过 APC 进行适度的前玻璃体切除术(在最初放置 IOL 时),然后使 IOL 居中并清除粘弹性物质。
纳入了 6 只犬(比格犬、德国牧羊犬、骑士查理王小猎犬、法国指示猎犬、美国斗牛犬、比格猎狐犬),年龄 11 至 94 个月(平均 51.8)。平均随访时间为 15.5 个月(范围 10-22)。在随访期间,每只眼均保持了透明的囊轴向透明性和位置良好的 IOL,没有发生并发症,从而保留了视力功能。
APC 联合适度的前玻璃体切除术似乎可有效治疗犬白内障手术中阻碍视轴的明显轴向 PCO。