Trans‐corneal reduction of anterior lens luxation in dogs with lens instability: a retrospective study of 19 dogs (2010–2013)

Abstract

Trans-corneal reduction of ALL provides a non-surgical alternative to intracapsular lens extraction (visual eyes) or enucleation (nonvisual eyes) in dogs. Long-term visual outcome of TR-ALL is comparable to intracapsular lens extraction for ALL.

Medical Treatment of Primary Canine Glaucoma

“…49 Despite this, they have been used successfully to medically treat posterior and subluxation of the crystalline lens in canine patients. 15,64 Due to their propensity to disrupt the blood-aqueous barrier, topical prostaglandin analogues should be used with caution in cases of glaucoma secondary to uveitis. 49,65 Recent reports in the human literature are challenging this relative contraindication.…”

Canine Secondary Glaucomas

“…Furthermore, if repositioning fails, ICLE is necessary and also requires a veterinary ophthalmologist. 78 In patients with subluxations or posterior luxations, long-term medical management with miotics, additional antihypertensives, and antiinflammatories may be possible. 75,79 Surgical removal of a subluxated or posteriorly luxated lens is a consideration but may cause more harm than good, particularly if surgical removal requires disruption of the vitreous.…”

“…77 Transcorneal repositioning or reduction is achieved via changes in head position and manipulation of the globe; once the lens is posterior to the iris, miotics are applied to maintain the lens in the posterior segment. 78 Although transcorneal repositioning sounds simple, its success depends on the underlying state of the vitreous and on an accurate analysis of the position of the pupillary margin with relation to the lens, which typically requires a slit lamp for evaluation. If miotics are applied prematurely or with the pupillary margin still posterior to the lens, or if significant liquefied vitreous still occupies the pupil, the procedure will fail and the glaucomatous crisis may be worsened.…”

“…79 Success rates for transcorneal repositioning in dogs with anterior luxations were comparable with those for ICLE and medical management: 54.5% of dogs were visual at time of last follow-up and median time to vision loss was 12 months. 78 NEOPLASIA Intraocular neoplasia can be divided broadly into 2 types: primary and metastatic. Melanoma was the most common primary intraocular tumor associated with Canine Secondary Glaucomas glaucoma in dogs in one study.…”

Lens-Related Emergencies: Not Always So Clear

“…Transcorneal reduction (couching) of the lens into the posterior chamber (i.e., behind the iris) or vitreous chamber may be successful along with continuous use of pharmacological medications that cause miosis and control IOP. 20 The most common medications used for this are prostaglandin analogs, such as latanoprost. This procedure is not successful in cats and should not be attempted without prior training as irreversible damage can result and the procedure itself can be painful if not performed correctly.…”