Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC.
K.R. Love QCC, Athens, GA.
J Am Vet Med Assoc. 2024 Sep 19;262(S2):S15-S24. doi: 10.2460/javma.24.05.0309. Print 2024 Dec 1.
To determine whether novel pre- and postsurgical ultrasound biomicroscopy (UBM) measurements of the canine ciliary cleft (CC) are associated with postoperative ocular hypertension (POH) following cataract surgery and to explore the relationship between intraocular pressure and CC UBM measurements.
Following pharmacologic mydriasis, UBM images were obtained from 31 client-owned dogs before elective cataract surgery, immediately postsurgery, and 4 to 6 hours following surgery or while experiencing POH ≥ 25 mm Hg. Presurgery and the pre- to postsurgery change in CC measurements were assessed for association with POH using individual mixed-effects logistic regression models and forward variable selection models. Linear mixed-effects models were used to evaluate the relationship of intraocular pressure to UBM measurements within the same eye across multiple time points.
Presurgical measurements were not predictive of POH development. An increase in pectinate ligament distance and CC area from presurgical baseline to immediate postsurgical measurement was associated with reduced odds of developing POH, while increasing CC length (from apex to mid point on the pectinate ligament) from pre- to postsurgery and immature cataracts was associated with increased odds of POH.
The change in CC morphology following cataract surgery appears more impactful in the development of POH than individual variations in presurgery CC measurements. Several changes in the CC dimensions following surgery appear associated with POH risk.
This understanding of a potential mechanism of POH development opens new avenues for researching preventative measures associated with modifying surgical techniques to influence CC morphology following cataract surgery.
确定犬类睫状沟(CC)的新术前和术后超声生物显微镜(UBM)测量值是否与白内障手术后的眼内高压(POH)有关,并探讨眼压与 CC UBM 测量值之间的关系。
在药物散瞳后,对 31 只患犬在接受择期白内障手术前、术后即刻和术后 4 至 6 小时或出现≥25mmHg 的 POH 时获取 UBM 图像。使用个体混合效应逻辑回归模型和向前变量选择模型评估术前和 CC 测量值从术前到术后的变化与 POH 的关系。线性混合效应模型用于评估同一眼在多个时间点的眼压与 UBM 测量值之间的关系。
术前测量值与 POH 发展无关。从术前基线到术后即刻测量,睫状韧带距离和 CC 面积的增加与 POH 发生的几率降低相关,而从术前到术后,CC 长度(从睫状韧带顶点到中点)的增加和不成熟白内障与 POH 发生的几率增加相关。
白内障手术后 CC 形态的变化似乎比术前 CC 测量的个体差异对 POH 的发展更有影响。手术后 CC 尺寸的几个变化似乎与 POH 风险相关。
对 POH 发展潜在机制的这种理解为研究与改变手术技术以影响白内障手术后 CC 形态相关的预防措施开辟了新途径。