Scleral approach for extracapsular cataract extraction in dogs

Abstract

The effectiveness of scleral approach for extracapsular cataract extraction was studied in six dogs (seven cases). Dogs presented with the history of impaired vision were clinically examined and cases with cataract were selected for the study. All dogs were put on to medication with azathioprine orally and ciprofloxacin, flurbiprofen and tropicamide topically three days prior to surgery. General anaesthesia was induced with atropine - xylazine - ketamine given intramuscularly and maintained with xylazine - ketamine - diazepam combination given intravenously. A scleral incision, two millimeters away and parallel to the limbus on the dorsolateral aspect was used to access the anterior chamber. Anterior capsulotomy was performed and lens was extracted. Collapse of anterior chamber was prevented by infusing the visco-elastic material, hydroxy propyl methyl cellulose. Sterile isotonic balanced salt solution was used to irrigate the anterior chamber. Scleral incision was sutured with 8/0 silk in simple interrupted pattern. Postoperatively all the dogs were maintained on cephalexin, azathioprine orally and ciprofloxacin, flurbiprofen and tropicamide topically. Scleral wounds were healed uneventfully and sutures were removed on 10th postoperative day. Major intraoperative complications encountered during the study were haemorrhage from the conjunctival incision, prolapse of iris, miosis and remnants of lens material in the anterior chamber. Out of the seven cases, four achieved functional vision by one month and corneal clarity except at the dorsolateral aspect near the suture line and in the remaining three, cornea remained opaque. Postoperative complications encountered were persistent corneal oedema in three cases, mild increase in intraocular pressure in two and vitreous prolapse in one.