Abstract
Purpose:
To characterize canine keratoconjunctivitis sicca (KCS) following phacoemulsification and the response of affected patients to lacrimostimulant therapy.
Methods:
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.
Results:
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.
Conclusions:
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.
Keywords: 486 cornea: tears/tear film/dry eye •
445 cataract