Endocyclophotocoagulation by pars plana approach in the management of refractory glaucoma with prior phacoemulsification and Ahmed gonioimplantation in a dog.

PURPOSE: To describe successful intraocular pressure control of refractory glaucoma and vision preservation with an endocyclophotocoagulation (ECP) procedure by pars plana approach. ANIMAL STUDIED: An 8-year-old, female-spayed, mixed-breed goniodysgenic dog with glaucoma following phacoemulsification with intraocular lens placement (IOL) refractory to maximized medical therapy and Ahmed gonioimplantation in both eyes (OU). PROCEDURES: For the first glaucoma interventional surgery, bilateral goniovalve implantation was performed following cataract surgery. A goniovalve was implanted in the left eye (OS) 2-days post-phacoemulsification, and 14-days post-phacoemulsification in the right eye (OD). Short-term intraocular pressure (IOP) control was achieved. However, glaucoma recurred 41-days post-phacoemulsification OU, and an endocyclophotocoagulation by pars plana approach was performed OU to treat 300° of the ciliary body with a 23-gauge argon laser endoscope. RESULTS: Th ECP pars plana approach was successful in obtaining IOP-control and vision preservation during a 15-month follow-up period. No intraoperative complications were encountered. Short-term postoperative complications included intraocular inflammation with fibrin and postoperative ocular hypertension. Intraocular pressure-control and vision preservation were maintained at the last follow-up examination, 15 months postoperative pars plana ECP. CONCLUSION: Endocyclophotocoagulation by pars plana approach achieved long-term (>1 year) IOP-control, preserved vision, and reduced the number of anti-glaucoma medications following failure of previous Ahmed gonioimplantation for uncontrolled glaucoma. This is the first case report of an endocyclophotocoagulation procedure by a pars plana approach for uncontrolled glaucoma following Ahmed gonioplantation. With the appropriate skill set, this novel surgical approach can be considered as a surgical intervention for glaucoma in canine patients.

Refractive state following retinal reattachment and silicone oil tamponade in dogs.

OBJECTIVE: To evaluate the refractive error induced by intraocular administration of silicone oil (SiO) in dogs. ANIMALS: 47 client-owned dogs evaluated for blindness secondary to retinal detachment. PROCEDURES: -3-port pars plana vitrectomy with perfluoro-octane and SiO exchange (1,000- or 5,000-centistoke SiO) was performed in 1 or both eyes for all dogs (n = 63 eyes), depending on which eye or eyes were affected. Dogs were normotensive, had complete oil filling of the eyes, and were examined in a standing position for retinoscopic examination of both eyes (including healthy eyes). RESULTS: The mean refractive error for SiO-filled phakic and pseudophakic eyes was 2.67 and 3.24 D, respectively. The mean refractive error for SiO-filled aphakic eyes was 6.50 D. Dogs in which 5,000-centistoke SiO was used had consistently greater positive refractive errors (mean, 3.45 D), compared with dogs in which 1,000-centistoke SiO was used (mean, 2.10 D); however, the difference was nonsignificant. There was no significant linear relationship between refractive error and the number of days between surgery and retinoscopy. CONCLUSIONS AND CLINICAL RELEVANCE: Hyperopia was observed in all dogs that underwent SiO tamponade, regardless of lens status (phakic, pseudophakic, or aphakic). Aphakic eyes underwent a myopic shift when filled with SiO. Pseudophakic eyes appeared to be more hyperopic than phakic eyes when filled with SiO; however, additional investigation is needed to confirm the study findings.