Managing cloudy back eye capsule during dog cataract surgery

Abstract

BACKGROUND: Posterior capsular opacification (PCO) is a cause of decreased vision after canine cataract surgery. PCO can appear in the months following surgery but can also be present at the time of surgery. AIMS: To describe the intraoperative management of marked axial PCO during canine cataract surgery through a retrospective case series study of six cases. METHODS: Six dogs (six eyes) with cataracts were included in this study. A complete ophthalmologic examination including electroretinography and ocular ultrasound was performed. After conventional phacoemulsification, a marked PCO obstructing the visual axis was found in five cases, previously diagnosed by ultrasound in the sixth. An axial posterior capsulorhexis (APC) was performed in all cases, before or after implantation of the intraocular lens (IOL). For the four cases implanted before APC, the posterior capsule (PC) was visualized either by positioning the IOL laterally in the bag with viscoelastic or through the optic of the implant. After perforation of the PC with a 30-Gauge needle, APC was initiated with Vannas curved scissors, then finalized with Utrata forceps to obtain a circular axial opening (3 mm diameter). In each case, a moderate anterior vitrectomy was performed through the APC (under the IOL when initially placed), then the IOL centered and the viscoelastic was removed. RESULTS: Six dogs (Beagle, German Shepherd, Cavalier King Carles, French pointing dog, American bully, Beagle Harrier) aged 11 to 94 months (mean 51.8) were included. The mean follow-up period was 15.5 months (range 10-22). Visual function with capsular axial transparency and well-centered IOL, without complications during the follow-up period, was preserved for each eye. CONCLUSION: APC combined with moderate anterior vitrectomy appears to be effective in the treatment of marked axial PCO obstructing the visual axis during canine cataract surgery.