RESUMEN
OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONs: 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. CLINICAL RELEVANCE: 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.
RESUMEN
OBJECTIVE: To evaluate whether intracameral tissue plasminogen activator (tPA) injection is effective in regulating posterior capsular opacification (PCO), fibrin formation and intraocular pressure (IOP) after cataract surgery. ANIMAL STUDIED: Prospective study involving 30 eyes of 21 dogs that underwent phacoemulsification. PROCEDURES: Thirty eyes were randomly divided into two groups of 15 eyes (control and tPA groups). Intracameral tPA (25 µg/0.1 mL) was injected into tPA group eyes before corneal incision closure but not into the eyes of the control group. The grades of anterior fibrin formation and PCO were compared based on slit lamp biomicroscope examination at 1 and 2 weeks, 1 month, and 2-3 months postoperatively. IOP was measured using applanation tonometry every 30 min for 4 h immediately after operation and on the following morning. The IOP of the two groups at each time was compared. RESULTS: The grade of anterior fibrin formation and that of PCO were not significantly different between the two groups at any time point (p > .05). However, the IOP of the tPA group was significantly lower than that of the control group at each point on the day of surgery (p < .05). No complications were observed with tPA injection, except for temporary hyphema (for 3 days) in one eye. CONCLUSIONS: Although the intracameral tPA injection did not affect anterior fibrin formation and PCO, it effectively maintained normal IOP immediately after phacoemulsification. Thus, our findings provide valuable insights into the potential benefits of intracameral tPA injection in achieving immediate IOP control after phacoemulsification.
RESUMEN
OBJECTIVE: To compare the effects of topical 0.005% latanoprost (L) vs combined 0.005% latanoprost and 1% atropine (LA) on control of postoperative ocular hypertension (POH), development of posterior synechiae formation, pupil size, and blindness after phacoemulsification surgery in dogs. ANIMAL STUDIED: Dogs with postoperative ocular hypertension were included in the study: L-group, latanoprost (eight dogs, 14 eyes) and LA-group, latanoprost and atropine (nine dogs, 15 eyes). PROCEDURES: Complete ophthalmic examinations including tonometry were performed at 1, 7, and 21 days following phacoemulsification. RESULTS: No significant differences were found between the measured intraocular pressure (IOP) at days 1 and 7 postphacoemulsification surgery in the L-group and the LA-group (P = 0.26 [14.12 ± 1.76 mmHg vs 16.96 ± 1.68 mmHg] and P = 0.71 [15.45 ± 1.43 mmHg vs 16.20 ± 1.36 mmHg], respectively). No significant differences were found between pupil sizes at day 7 for the two groups (P = 0.25 [13.83% vs 24.77%]). No significant differences were found between odds of posterior synechiae formation at day 21 (P = 0.92) with a probability ± SE for L-group vs LA-group at 0.27 ± 0.14 vs 0.25 ± 0.13. No significant differences were found in odds of postoperative blindness between groups (P = 0.58) with a probability ± SE of 0.21 ± 0.11 vs 0.13 ± 0.09, respectively for L and LA. CONCLUSIONS: Combined topical latanoprost and atropine in dogs maintains normal postoperative IOPs but does not seem to cause increased mydriasis compared to latanoprost alone.
Asunto(s)
Atropina/uso terapéutico , Enfermedades de los Perros/tratamiento farmacológico , Latanoprost/uso terapéutico , Hipertensión Ocular/veterinaria , Soluciones Oftálmicas/uso terapéutico , Facoemulsificación/veterinaria , Complicaciones Posoperatorias/veterinaria , Animales , Atropina/administración & dosificación , Ceguera/etiología , Ceguera/prevención & control , Ceguera/veterinaria , Catarata/veterinaria , Perros , Quimioterapia Combinada/veterinaria , Femenino , Latanoprost/administración & dosificación , Implantación de Lentes Intraoculares/veterinaria , Masculino , Hipertensión Ocular/tratamiento farmacológico , Hipertensión Ocular/etiología , Facoemulsificación/efectos adversos , Complicaciones Posoperatorias/tratamiento farmacológico , Estudios RetrospectivosRESUMEN
OBJECTIVE: To determine whether topical hypotensive medications prevent postoperative ocular hypertension (POH) after phacoemulsification. ANIMALS STUDIED: 52 client-owned dogs (88 eyes). PROCEDURES: Diabetic and nondiabetic dogs having undergone phacoemulsification were included in this retrospective study. The control group received no ocular hypotensive medications. The treatment groups received latanoprost, dorzolamide, or dorzolamide/timolol, beginning immediately after surgery, for 2-week duration. IOPs were obtained at initial examination followed by 4 h, 24 h, 7 days, and 14 days postoperatively. POH was defined as an IOP above 20 mmHg (POH20) or 25 mmHg (POH25). RESULTS: POH20 occurred in 33 of 87 eyes (37.93%), including 11 of 21 eyes (52.38%) in the control group, three of 23 eyes (13.04%) in the latanoprost group, eight of 15 eyes (53.33%) in the dorzolamide group, and 11 of 28 eyes (39.29%) in the dorzolamide/timolol group. Active treatment groups were compared to the control group, and the overall group effect was not significant (P = 0.11). POH25 occurred in 22 of 86 eyes (25.58%), including seven of 21 eyes (33.33%) in the control group, two of 23 eyes (8.70%) in the latanoprost group, five of 15 eyes (33.33%) in the dorzolamide group, and eight of 27 eyes (29.63%) in the dorzolamide/timolol group. Active treatment groups were compared to the control group, and the overall group effect was not significant (P = 0.31). Intraoperative use of intracameral tissue plasminogen activator significantly decreased the chances of POH25 (P = 0.0063). CONCLUSIONS AND CLINICAL RELEVANCE: The latanoprost group had a substantially lower percentage of POH 20 and POH25 compared to the control and other active treatment groups, although statistical significance was not achieved. Intraoperative intracameral tissue plasminogen activator decreased the incidence of POH25.