Application of local anaesthesia and cryosurgery for eyelid masses in dogs.

BACKGROUND: Eyelid mass removal and cryotherapy application using only local anaesthesia and restraint may benefit patients with high anaesthesia risks. OBJECTIVE: To evaluate and validate cryosurgery application using the CryoPen XL® on palpebral masses under local anaesthesia for patients not suitable for general anaesthesia. METHODS: Thirty patients underwent the procedure between November 2015 and April 2020. The procedure steps were as follows: skin preparation and local anaesthesia of the affected eyelid; debulking by resection and/or squeezing out the inspissated material; cryosurgery and post-operative care using topical medication, antibiotics and anti-inflammatory ointment. The medical records of the patients who underwent the operation were evaluated. Moreover, a telephonic survey with the pet owners was performed to determine recurrence, time to recurrence, survivability and side effects. RESULTS: Among the 30 owners, 29 responded to the survey. Ten (10/38, 26.3%) masses recurred with an average time to recurrence of 6.0 months. The estimated average depths for all, non-recurred, and recurred masses were 1.89, 1.88 and 1.90 mm, respectively. The average recurrence rate and time to recurrence were higher and earlier, respectively, than previously reported values. However, no patient presented intra- or post-operative complications. CONCLUSION: These findings suggest that local anaesthesia and cryosurgery using the CryoPen XL® can be used in patients with eyelid masses who are not suitable for general anaesthesia. Compared with the surgical eyelid mass removal and blepharoplasty procedure, the reported procedure is time- and cost-effective, with the additional benefit of not requiring general anaesthesia.

Regional anesthesia as an adjunct for eyelid surgery in dogs.

Eyelid surgery plays an important role in the management of a variety of ophthalmic diseases. Surgery on the adnexa and eye is routinely performed on an anesthetized patient. Minor procedures, such as conjunctival biopsy, may be performed in an awake patient using only topical anesthesia. Retrobulbar, peribulbar, and local anesthesia are less commonly used in general practice; however, they can provide significant advantages when used appropriately. Advantages to local anesthesia/sedation include being able to perform some ophthalmic procedures without having to place the patient under general anesthesia, ability to maintain the patient under a lighter plane of general anesthesia, improved postoperative comfort, and potentially smoother recoveries from general anesthesia. This article reviews this author's current indications and techniques for regional anesthesia as an adjunct to eyelid surgery in dogs.