Reassessing Antibiotic Use in Canine and Feline Eyelid and Third Eyelid Surgeries: An Observational Study Supporting Selective Prophylaxis.

Abstract

PURPOSE: This study aimed to evaluate postoperative outcomes in dogs and cats undergoing eyelid and third eyelid surgeries without routine prophylactic antibiotic use. METHODS: This observational study included 96 animals (71 dogs and 25 cats) that underwent 163 eyelid and third eyelid procedures between March 2024 and November 2025. Animals were divided into four groups: no antibiotics, topical only, systemic only, or both topical and systemic. Prophylactic antibiotics were administered only when predefined clinical criteria were met, including prolonged surgical duration, breach of aseptic protocol, comorbidities, or concurrent otitis or dermatitis. Postoperative complications were classified according to an adapted Clavien-Dindo system (Grades I-V), based on the level of intervention required. RESULTS: Seventy animals underwent surgery without antibiotics, 12 received topical antibiotics only, four received systemic antibiotics only, and nine received both topical and systemic antibiotics. Two cases of postoperative suture dehiscence occurred: one in a cat from the combined topical and systemic antibiotic group after a Read and Broun procedure, and one in a dog from the no-antibiotic group after a bilateral Kuhnt-Szymanowski procedure. Both were classified as grade II, as they resolved with medical management. CONCLUSION: Withholding prophylactic antibiotics unless predefined risk factors were present did not increase the rate of postoperative complications in eyelid and third eyelid surgery. A restrictive and rational antibiotic protocol, based on clearly defined criteria, may therefore support responsible antimicrobial use in veterinary ophthalmology.