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R Whitley, Hannah Visser, Kyle Tofflemire, Elizabeth Whitley, Rachel Allbaugh, Gil Ben-Shlomo; Decreased Tear Production in Dogs Following Phacoemulsification. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4346.
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To characterize canine keratoconjunctivitis sicca (KCS) following phacoemulsification and the response of affected patients to lacrimostimulant therapy.
Medical records of dogs diagnosed with KCS following phacoemulsification and aspiration for cataracts from 2005 to 2012 were reviewed. Only dogs with complete medical records and at least 6 months of post-op follow-up were included. KCS was diagnosed by a STT-1 below 15 mm/min and clinical signs. Dogs treated with lacrimostimulants before surgery were excluded. Information collected included: signalment, weight, time between surgery and diagnosis of KCS, STT-1 values recorded before phacoemulsification and at diagnosis of KCS, diabetic status, age at surgery, and outcome of KCS treatment.
Two hundred and forty eight dogs undergoing phacoemulsification and aspiration were identified, 137 were excluded per above criteria, leaving 111 cases for review. Seventeen of the 111 (15%) dogs developed KCS, and 12 of 17 (71%) were diabetic. Bilateral surgery was performed on 15 of the 17 dogs, and unilateral surgery was performed on two diabetic dogs for a total of 32 eyes. Of the 17 dogs, 3 had untreated unilateral KCS prior to bilateral cataract surgery. Following surgery, an additional 26 eyes were diagnosed with KCS. The age of affected dogs was 8 ± 2.8 years. Affected dogs included 8 spayed females, 7 castrated males, and 2 intact males. The weight of affected dogs was 16 ± 14.3 kg, with 10 dogs (59%) weighing 10 kg or less. STT-I was 16 ± 3 mm/min pre-operatively and 9 ± 4.4 mm/min at the time of post-operative KCS diagnosis. The decrease in STT was 7 ± 5.4 mm/min. The post-operative interval to KCS diagnosis was 196 ± 222 days. Of the 17 dogs diagnosed with post-operative KCS, 16 were treated with topical cyclosporine or tacrolimus in various concentrations and frequencies. In 17 eyes of 9 dogs, tear production was improved by 7 ± 6 mm/min at the last follow-up, 466 ± 325 days. In 10 eyes (38%) of 6 dogs, KCS had resolved over a period of 238 ± 184 days; however, only 2 (17%) diabetic dogs experienced resolution of KCS.
Dogs undergoing phacoemulsification and aspiration are at risk for development of KCS. Diabetics and miniature schnauzers are overrepresented. Lacrimostimulant therapy was usually successful in these patients.
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