Feasibility of aqueous shunts for reduction of intraocular pressure in horses.

REASONS FOR PERFORMING STUDY: Based on the current literature, neither medical, surgical nor combination therapy adequately controls equine glaucoma for many horses. Aqueous shunts have been useful in other species to control glaucoma. OBJECTIVES: To determine whether aqueous shunts in normal equine eyes significantly reduce intraocular pressure (IOP) without causing vision threatening complications. STUDY DESIGN: Prospective experimental trial. METHODS: Aqueous shunts were placed in 7 normal eyes of 4 horses. The shunts were placed dorsotemporally. Examinations were initially performed daily for 7 days and after that every 3 days through 4 weeks after implantation. Horses were then subjected to euthanasia and globes enucleated for routine histological examination. The IOPs for each day post operatively were compared to the preoperative value (Day -1) using a Wilcoxon signed ranks test. Significance was set at P<0.05. RESULTS: The mean IOP preoperatively (20.7 ± 3.0 mmHg) was significantly higher than on any post operative day (P values ranged from 0.018 to 0.048). The aqueous shunts remained in situ for the entire study. Two eyes developed corneal ulcers that resolved. Shallow anterior chambers were noted in 2 eyes after shunt placement, which normalised after placement of full eye cup masks. Histologically, 7/7 eyes had fibrosis surrounding the implant. Minimal peripheral neovascularisation and neutrophilic keratitis were noted in 5/7 eyes. Corneal damage was scored as none in 3/7, mild in 2/7, moderate in 1/7 and marked in 1/7 eyes. CONCLUSIONS: After placement of aqueous shunts, a significant decrease in IOP was noted from preoperatively (Day -1) to Day 28 despite fibrosis surrounding the implants. No vision threatening complications were noted. POTENTIAL RELEVANCE: Aqueous shunts may represent a feasible therapeutic option for equine glaucoma. The results of this study suggest that further studies in glaucomatous horses would be warranted.

A pilot study on the corneal curvatures and ocular dimensions of horses less than one year of age.

Intraocular lenses (IOLs) have been implanted in adult equine eyes after cataract surgery. Foals and weanlings comprise a large proportion of those horses undergoing cataract surgery. Due to potential differences in the size and corneal curvature of the juvenile eye, it is not currently known whether implantation of adult IOLs is appropriate in foals and weanlings. The objective of the study was to measure the anterior chamber depth (ACD), central lens thickness (CLT), vitreous chamber depth (VCD), axial globe length (AGL) and corneal curvature of horses less than one year of age. The axial dimensions from one eye of 10 foals were measured using simultaneous A and B scan ultrasonography. The corneal curvature from one eye of 7 weanlings was determined using a modified photokeratometer. Ultrasonography revealed a mean ACD of 4.94 mm, mean CLT of 9.38 mm, mean VCD of 18.96 mm and mean AGL of 33.32 mm for the foals. The mean corneal curvature was 15.4 diopters (D). The mean ACD, CLT, VCD and AGL of the foals were less than the measurements reported in the literature for adult horses. The mean corneal curvature was similar to the values reported by some authors for adult horses. Due to the differences in axial dimensions between adult and juvenile eyes, an IOL that corrects vision in an adult horse might not adequately correct vision in a horse less than one year of age.

Phacoemulsification and implantation of foldable +14 diopter intraocular lenses in five mature horses.

Presently, intraocular lenses (IOLs) are not routinely implanted after equine cataract surgery. Subsequently, horses are visual but markedly farsighted (hyperopic). This report describes the surgical results and visual status after phacoemulsification and implantation of IOLs in mature horses with spontaneous cataracts. Six eyes of 5 mature horses underwent phacoemulsification and implantation of a +14 diopter (D) foldable IOL. Recheck ocular examinations were performed at 1, 4 and 24 weeks post operatively. Refractive error was recorded at 4 weeks post operatively. Visual status, refractive error and anterior chamber depth were recorded 24 weeks post operatively: 5 of 6 operated eyes remained visual and the average refractive error was +0.4 ± 1.1D. There was a significant difference between the 24 week post operative refractive error and the population mean of +10D (P<0.0001) for aphakic horses. The average post operative anterior chamber depth was 7.89 ± 1.55 mm. One globe was enucleated 2 months post operatively. Phacoemulsification with IOL implantation resulted in a significant reduction in post operative refractive error and restored vision to within 0.4D of emmetropia in 5 of 6 operated eyes. Implantation of a +14D IOL ameliorated the hyperopia documented in aphakic horses and improved the post operative visual acuity.