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Peer-reviewed veterinary case report

Symblepharon eye condition in kittens - types and treatment outcomes

By Shiraishi, Hikaru et al.·Published in Journal of feline medicine and surgery·2023·School of Veterinary Medicine, United States·View original on PubMed

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Original publication title: Symblepharon in kittens: a retrospective study of 40 kittens and 54 eyes (2002-2022).

Species:
cat

Plain-English summary

A group of 40 kittens, aged 3 to 46 weeks, were treated for a condition called symblepharon, which involves abnormal adhesions in the eyes. Symptoms included eyelid deformities and various types of adhesions between the eyelids and conjunctiva. Some kittens were treated with medications, while others required surgery to separate the adhesions. Most kittens showed improvement after surgery, although some still had persistent issues. Despite the challenges, many kittens retained some vision, as indicated by their ability to respond to visual stimuli.

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Abstract

OBJECTIVES: The aim of this study was to retrospectively evaluate the signalment, treatment, surgical technique and outcomes for feline symblepharon. METHODS: A retrospective medical record review and standardized grading of clinical descriptions and photographs was undertaken. RESULTS: Forty kittens (54 eyes) aged 3-46 weeks had symblepharon of five types in various combinations: eyelid deformation (24 kittens; 32 eyes); ankyloblepharon (four kittens; four eyes); conjunctiva-to-conjunctiva (11 kittens; 12 eyes); third eyelid-to-conjunctiva (24 kittens; 29 eyes); and corneoconjunctival adhesions (14 kittens; 16 eyes). At initial presentation, 23 (43%) eyes were affected by one type of symblepharon, 25 (46%) eyes by two types and six (11%) eyes by three types; 11 (20%) corneas were ulcerated. Twenty-four (44%) eyes of 18 (45%) kittens were managed medically. Surgery was performed under general anesthesia/sedation (30 occasions) or topical anesthesia (21 occasions) on 30 (56%) eyes of 22 kittens; 12 eyes (40%) underwent multiple surgeries. Four techniques were commonly employed: separation of conjunctival-to-conjunctival adhesions ± eyelid margins (14 eyes); resection of third eyelid adhesions ± temporary tacking of the third eyelid (modified Arlt's pterygium technique; 18 eyes); en bloc resection of the third eyelid (two eyes); and separation of corneoconjunctival adhesions (14 eyes). Median duration of follow-up was 55 days (range 1-1051). Median symblepharon grade in kittens treated surgically improved for all types except corneoconjunctival symblepharon. Median symblepharon grade in kittens receiving medical management remained the same or improved. Corneoconjunctival symblepharon opacity decreased for eyes treated surgically but increased for eyes treated medically. Three eyes were enucleated due to complications of corneoconjunctival symblepharon. At final presentation, symblepharon persisted in 46 (85%) eyes; however, menace response was evident in 13/16 eyes and dazzle reflex in 23/23 eyes. CONCLUSIONS AND RELEVANCE: Symblepharon is a heterogeneous group of conditions with diverse anatomic involvement, clinical appearance and impact, optimal treatment and prognosis for vision.

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Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/36745097/