Causes, outcomes, and owner satisfaction of dogs undergoing enucleation with orbital implant placement.

OBJECTIVE: To describe clinical and histopathologic pre-operative diagnoses as well as associated post-operative complications following orbital silicone implantation in dogs undergoing enucleation and evaluate owner satisfaction. ANIMALS STUDIED: One hundred and eighty-six dogs who underwent enucleation with orbital implant. PROCEDURES: Medical records from dogs that underwent enucleation with orbital implant performed at Virginia-Maryland Veterinary Teaching Hospital between 2007 and 2019 were reviewed. Owners were surveyed via telephone regarding client satisfaction. RESULTS: Enucleation followed by orbital implant placement occurred in 215 eyes of 186 dogs. The most common pre-operative diagnoses were glaucoma (68.8%), uveitis (17.7%), cataracts (15.8%), intraocular neoplasia (13.0%), and lens luxation (10.7%). The most common histopathologic diagnoses were retinal degeneration (46.5%), uveitis (39.5%), cataract (29.8%), retinal detachment (27.4%), and secondary glaucoma (26.5%). Fourteen eyes (6.5%) from ten dogs had post-operative complications reported including orbit cellulitis (n = 11), implant migration (n = 1), and implant extrusion (n = 1). Five of these dogs (50%) had concurrent diabetes mellitus. Median complication time from surgery was 41 days (range: 11-541 days). Ninety-five owner survey responses were completed with a median time of 6.3 years following surgery. Most owners, 85.3% (n = 81), were satisfied with the post-operative outcome. CONCLUSION: Enucleation with implantation of an orbital implant is a viable and safe method for irreversibly blind eyes. Diabetes mellitus may be a risk factor for the development of post-operative complications. Intraocular neoplasia was not associated with development of post-operative complications. Results of this study indicated high owner satisfaction rates for improving cosmetic appearance after enucleation in dogs.

A retrospective analysis of the risk factors for surgical site infections and long-term follow-up after transpalpebral enucleation in horses.

BACKGROUND: Implants are often used to improve the cosmetic appearance of horses after enucleation of the eye. When surgical site infection (SSI) occurs, the implant will almost always be lost. The aim of this study is to collect data on the risk factors for SSIs and report long-term follow-up (cosmetic results and return to work) after transpalpebral enucleations. In this retrospective study, records of horses undergoing transpalpebral enucleation were reviewed (2007-2014) and telephone interviews were used to obtain long term follow-up. The potential risk factors for SSIs (indication for enucleation, use of an implant, standing procedures, duration of surgery, opening of the conjunctival sac and prolonged use of antimicrobials) were analysed for their association with the outcome measure 'SSI' vs 'no SSI' by multivariable binary logistic regression testing. Indications for enucleation were grouped as follows: Group 1 (clean) included equine recurrent uveitis, too small or too large globes, and intraocular tumours, Group 2 (non-clean) included corneal perforation/rupture and infected ulcers and Group 3 (tumour) included extraocular tumours. RESULTS: One hundred and seven cases of enucleation were evaluated. An implant was used in 49 horses. The overall number of SSIs was 8 (7.5%). Multivariable logistic regression testing showed implants (OR 7.5, P = 0.04) and standing procedures (OR 12.1; P = 0.03) were significantly associated with the percentage of SSIs and increased the risk of SSI. The eyes of horses in Groups 2 and 3 trended towards a larger risk for developing SSIs (OR 4.9; P = 0.09 and OR 5.9; P = 0.1, respectively). Prolonged use of antimicrobials, long surgery times and the opening of the conjunctival sac during dissection did not show significant associations with SSI risk. CONCLUSIONS: The risk of SSI after enucleation is low in clean eyes and when no implant is used. Placing an implant or performing a standing enucleation significantly increases the risk of SSIs. Although implants can be used for eyes that fall into Groups 2 and 3, 17% of the horses in these two groups developed an SSI leading to loss of the implant.

INTRAOCULAR SILICONE BALL IMPLANTATION AFTER EVISCERATION IN A SLOW LORIS (NYCTICEBUS COUCANG).

A slow loris, Nycticebus coucang , was brought to Ji Dong Beom Animal Hospital from the National Institute of Ecology due to globe enlargement and frequent blepharospasm of the right eye. Ophthalmic diagnoses included glaucoma with posterior lens luxation and cataract. Because this animal was on exhibition at the National Institute of Ecology, preservation of the eyeball by intraocular silicone implantation following evisceration rather than enucleation was selected. Before the surgery, examination of the normal left eye was performed using Retcam and spectral domain optical coherence tomography. Three months later, the globe size was almost the same as the left eye; however, corneal edema remained.

Polymethylmethacrylate orbital implants with interconnecting channels. A retrospective study following enucleation in dogs and cats.

PURPOSE: This study describes the use of polymethylmethacrylate implants with interconnecting channels (PIIC) to fill the orbit following enucleation in 31 dogs and 11 cats. METHOD: Seven channels were drilled into the implant. A central channel, running from the PIIC pole to its flat surface, was used to pass sutures anchoring the PIIC to the orbital fascia, minimizing the likelihood of extrusion. Six more channels allowed ingrowth of fibrovascular tissue into the PIIC, which reduces the risk of extrusion. Patients were evaluated 3, 10, and 30 days postoperatively, with 15 of 42 patients followed for 6-20 months. Ultrasound examination was performed in seven patients 15-510 days postoperatively, and two implants were studied histopathologically. RESULTS: Implants were well tolerated and prevented skin concavity, leading to good cosmetic results. Blood flow was imaged in vessels growing into the channels, and histopathologically a collagenous, fibrovascular capsule was seen surrounding the PIIC and invading its channels. CONCLUSIONS: PIICs are a safe and cosmetic solution to anophthalmic orbits, allowing ingrowth of blood vessels and fibrovascular tissue.