Combined iridencleisis and posterior sclerectomy in surgical treatment of glaucoma secondary to uveitis in a dog: a case report

Abstract

ABSTRACT:In early diagnosed and causally treated cases of secondary glaucoma, it is possible to save the sight in a glaucomatous eye and to preserve the sight in a healthy eye. The most common causes of secondary glaucoma include anterior uveitis, in which diverse pathological processes can lead to an increase in IOP. In cases of treating glaucoma secondary to uveitis with annular posterior synechiae in connection with peripheral anterior synechiae, iridencleisis is the method of choice. This article presents the results of the eight-month treatment of such a case with iridencleisis combined with posterior sclerectomy. This method makes it possible to increase the area of aqueous humour outflow to the subconjunctival space. The treatment resulted in the reduction of IOP in the left eye from the preoperative value of 72 mmHg to 15 mmHg, which was maintained at a constant level during the eight-month period following the surgery. Sight assessment in the operated eye, carried out on the basis of PLR, menace and dazzle response, brought a moderately positive result.Keywords: iridencleisis; sclerectomy; secondary glaucoma; dog Secondary glaucoma is the most common form of glaucoma in dogs (Smith et al., 1993;Barnett et al., 2002;Barnett, 2006). Unlike primary glaucoma, it is not a hereditary disease, but its causes may be (Curtis and Barnett, 1980;Gelatt and Brooks, 1999;Johnsen et al., 2006). In contrast to primary glaucoma, secondary glaucoma may involve only one eye; therefore, if the primary disease is diagnosed and the treatment is started early enough, the patient may not lose vision (Johnsen et al., 2006).Among the most common causes of secondary glaucoma in dogs are, anterior uveitis (Crispin, 1988;Abrams, 2001;Johnsen et al., 2006), lens displacement (Curtis and Barnett, 1980;Abrams, 2001;Gelatt and Gelatt, 2001;Gelatt and MacKay, 2004;Morris and Dubielzig, 2005;Johnsen et al., 2006), intumescent cataract (phacomorphic glaucoma) (Gelatt and Brooks, 1999;Gelatt and MacKay, 2004), intraocular cysts (Deehr and Dubielzig, 1998;Spiess et al., 1998;Sapienza et al., 2000), hyphema (Nelms et al., 1993;Sansom et al., 1994;Barnett et al., 2002), intraocular neoplasia (Dubielzig, 1990), ocular melanosis (pigmentary glaucoma) (Petersen Jones, 1991;van de Sandt et al., 2003).An accurate estimate of the most common direct cause of secondary glaucoma in dogs is possible with retrospective statistical studies. Therefore, it is obvious that the longer the period under study, the more representative the results will be. The results of a retrospective study by Johnsen et al. (2006) of a 5-year period indicate that the direct cause of over three quarters of all the cases of secondary glaucoma in dogs are anterior uveitis and lens dislocation. With the estimation criteria narrowed down, nonsurgical anterior uveitis alone accounted for nearly 45% of the group of dogs. Different data have been reported by Gelatt and MacKay (2004), who presented the results of a retrospective study of a 39-year period. According to the results of t...

Haemato-Biochemical Changes Associated with Comparison of Intra Ocular Lens (IOL) Implantation with and without Capsular Tension Ring (CTR) Placement Following Phacoemulsification in Cataractous Dogs

“…Neither surgical procedure nor anaesthetic protocol did not alter the biochemical parameters. Similar observations were also reported by Sudha (2005), Lew and Lew (2009), Hmar (2014), Madan (2015), Amitha (2016) and Suresh et al, (2019).…”

“…Similar findings were also reported by Lew and Lew (2009), Namratha (2012), Hmar (2014, Madan (2015), Amitha (2016) and Suresh et al, (2019). Since the technique involved minor surgical procedures which did not result in any major blood loss, no changes in haemoglobin levels were observed.…”