Posterior capsular opacification in diabetic and nondiabetic canine patients following cataract surgery

Abstract

Posterior capsular opacification (PCO) is the most common postoperative complication of contemporary cataract surgery. Limited information is available regarding PCO formation and factors that influence PCO development in the dog. Two hundred sixty-five eyes (144 from diabetic dogs and 121 from dogs with breed-related cataracts) were prospectively evaluated for PCO formation for up to 12 months postoperatively. The mean age of all dogs in the study was 7.77 years and diabetic dogs were significantly older than dogs with breed-related cataracts. There were 73 males (61 neutered, 12 intact) and 74 females (70 neutered, 4 intact) in the study. Statistical analysis was performed based on age, breed/size, gender, stage of cataract at the time of surgery, PCO score at each time point, breed-related vs. diabetic cataract, right eyes compared to left eyes, and presence/absence of uveitis. Age and gender did not significantly influence PCO formation. Small and medium-sized breeds developed significantly more PCO in comparison to the large/giant breeds at 2 weeks and 2-4 months postoperatively, but the differences were not significant at later time points. There was an overall significant increase in PCO formation in eyes with early immature cataracts when compared to other stages of cataract up to 4 months postoperatively but not at later time points. There were no statistical differences in PCO score at 6 months or at 1 year postoperatively in eyes with breed-related and diabetic cataracts. Right eyes did not differ from left eyes in PCO score. PCO score significantly increased over time in breed-related and diabetic groups and in the overall population. No difference was found in the degree of PCO formation in eyes with inflammation prior to or after surgery compared with those without inflammation. In summary, age, gender, presence of inflammation, and cause of cataract (breed-related vs. diabetes mellitus) do not influence the development of PCO in canine cataract dogs. Small and medium-sized breeds develop significant PCO earlier than larger breeds. It is important to note that all eyes from all dogs in this study developed PCO in a time dependent manner.

Avaliação da composição molecular da cápsula anterior da lente de cães idosos com catarata de alto risco

“…Estudo realizado anteriormente em humanos evidenciou que há aumento na expressão de proteínas na membrana extracelular das cápsulas colhidas de pacientes diabéticos, quando comparados às colhidas de pacientes sadios que apresentavam apenas cataratas do tipo corticais, o que supostamente poderia alterar a composição dos proteoglicanos nessa estrutura e, por consequência, sua função nestes pacientes (Tiwari et al 2014). Outros estudos referem que há uma maior produção de colágeno na presença de catarata e/ou diabete e que a alteração é ainda maior no grupo dos diabéticos, quando também comparados a pacientes sadios (Glover & Constantinescu 1997, Bras et al 2006, Pot et al 2009, Wormstone et al 2009, Chandler et al 2012. Diferente dos referidos estudos, não se observou diferença significante quanto ao aumento na expressão de proteínas (proteoglicanos) e/ou colágeno entre os grupos estudados.…”

Update on veterinary cataract surgery

“…The most common long-term postoperative complication of phacoemulsification cataract surgery is posterior capsular opacification (PCO) with a 100% incidence in dogs in one study [58] and 62% incidence in another recent study [20]. Both studies, though varied in PCO incidence, point out the importance of this postoperative complication.…”

“…The average time to significant clinical PCO in humans is 26 months after surgery, with a range of 3 months to 4 years [59]. A similar amount of PCO develops in dogs by 12 months postoperatively [58]. The acrylic IOLs available for use in dogs are hydrophilic, not hydrophobic.…”

Avaliação eletrorretinográfica pré e pós-operatória em cães diabéticos submetidos à facoemulsificação

“…Sabe-se que o tratamento para catarata diabética ou não, é cirúrgico, apresentando a mesma taxa de sucesso entre os dois grupos (BAGLEY; LAVACH, 1994;WILLIAMS et al, 1996;BRAS et al, 2006;WILKIE et al, 2006;KLEIN et al, 2011;MOELLER et al, 2011). Reabsorção espontânea da catarata diabética é rara e quando acontece, pode resultar em iridociclite grave irresponsiva ao tratamento, evoluindo para glaucoma ou phthisis bulbi.…”

“…No cão e no homem esta técnica cirúrgica é mais utilizada para a remoção da lente devido à pequena incisão, menor tempo cirúrgico e baixa lesão nas estruturas intraoculares, resultando em menores complicações, principalmente quanto inflamação (BAGLEY; LAVACH, 1994;BRAS et al, 2006;HONG et al, 2009;CHIURCIU et al, 2010;CRASTA et al, 2010;KLEIN et al, 2011;MOELLER et al, 2011). …”