Transpalpebral Eye Enucleation in 40 Standing Horses

Pollock, Patrick; Russell, Tom; Hughes, Thomas K.; Archer, Michael R.; Perkins, Justin

doi:10.1111/j.1532-950x.2008.00382.x

Cited by 65 publications

(64 citation statements)

References 7 publications

(12 reference statements)

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“…All horses received a retrobulbar block and, for horses undergoing a standing procedure, additional nerve blocks were performed as described in Pollock et al [6]. A standard transpalpebral enucleation was performed [1] and the same surgical technique was used for the standing and the recumbent procedures.…”

Section: Methodsmentioning

confidence: 99%

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A retrospective analysis of the risk factors for surgical site infections and long-term follow-up after transpalpebral enucleation in horses

2017

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BackgroundImplants are often used to improve the cosmetic appearance of horses after enucleation of the eye. When surgical site infection (SSI) occurs, the implant will almost always be lost. The aim of this study is to collect data on the risk factors for SSIs and report long-term follow-up (cosmetic results and return to work) after transpalpebral enucleations. In this retrospective study, records of horses undergoing transpalpebral enucleation were reviewed (2007–2014) and telephone interviews were used to obtain long term follow-up. The potential risk factors for SSIs (indication for enucleation, use of an implant, standing procedures, duration of surgery, opening of the conjunctival sac and prolonged use of antimicrobials) were analysed for their association with the outcome measure ‘SSI’ vs ‘no SSI’ by multivariable binary logistic regression testing. Indications for enucleation were grouped as follows: Group 1 (clean) included equine recurrent uveitis, too small or too large globes, and intraocular tumours, Group 2 (non-clean) included corneal perforation/rupture and infected ulcers and Group 3 (tumour) included extraocular tumours.ResultsOne hundred and seven cases of enucleation were evaluated. An implant was used in 49 horses. The overall number of SSIs was 8 (7.5%). Multivariable logistic regression testing showed implants (OR 7.5, P = 0.04) and standing procedures (OR 12.1; P = 0.03) were significantly associated with the percentage of SSIs and increased the risk of SSI. The eyes of horses in Groups 2 and 3 trended towards a larger risk for developing SSIs (OR 4.9; P = 0.09 and OR 5.9; P = 0.1, respectively). Prolonged use of antimicrobials, long surgery times and the opening of the conjunctival sac during dissection did not show significant associations with SSI risk.ConclusionsThe risk of SSI after enucleation is low in clean eyes and when no implant is used. Placing an implant or performing a standing enucleation significantly increases the risk of SSIs. Although implants can be used for eyes that fall into Groups 2 and 3, 17% of the horses in these two groups developed an SSI leading to loss of the implant.

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Section: Methodsmentioning

confidence: 99%

“…Transpalpebral enucleation is often performed with the horse anaesthetized and in lateral recumbency, but a standing procedure has also been described [6, 7]. The standing procedure eliminates the expense and risk of general anaesthesia, but asepsis may be more difficult to maintain, which may increase the risk of surgical site infection.…”

Section: Introductionmentioning

confidence: 99%

A retrospective analysis of the risk factors for surgical site infections and long-term follow-up after transpalpebral enucleation in horses

2017

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“…Transpalpebral enucleation in the standing horse is described as eliminating the risk and costs of general anaesthesia (Pollock et al 2008). Proper use of nerve blocks, topical analgesia and sedative drugs are necessary to perform this technique (Wilkie 1991).…”

Section: Discussionmentioning

confidence: 99%

“…Ocular procedures may also initiate severe blood loss, cardiac dysrhythmias, or cardiac arrest (Short and Rebhun 1980, Raffe et al 1986, Gasthuys et al 1988). Enucleation using a transpalpebral approach in the standing horse is described without causing severe complications like haemorrhage, bradycardia or hypotension (Hewes et al 2007, Pollock et al 2008). …”

Section: Introductionmentioning

confidence: 99%

Sedation management for standing enucleation of the left eye in a 37 years old horse with decompensated left heart failure

Hopster¹,

Kästner²

2013

PHK

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SummaryA 37 year old Arabian horse was presented for enucleation. Because of decompensated left heart failure and pulmonary oedema the decision for surgery in a standing position was made. The horse was sedated with acepromazine, levomethadone and xylazine and the supraorbital, lacrimal, infratrochlear and zygomatic nerve were blocked for desensitizing of the eyelids. In addition, an auriculopalpebral and a retrobulbar block were performed to obtain palpebral akinesia and to prevent the occurrence of the oculocardiac reflex. The eye was enucleated without any adverse effects with the horse standing calm and stable without any signs of pain.

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“…Operationen am Auge mit Lokal-und Regionalanästhesie sind zwar lange bekannt (Röder und Berge 1939, Westhues und Fritsch 1960. Sie werden in der Pferdemedizin aber eher selten angewendet, obwohl es dazu Pollock et al 2007, Pollock et al 2008, Tóth et al 2008, Tóth 2010.…”

Section: Introductionunclassified

Experiences with the local retrobulbar anesthesia in ophthalmologic surgery of the standing horse

Töth¹,

Hollerrieder²

2013

PHK

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Experiences with the local retrobulbar anesthesia in ophthalmologic surgery of the standing horse Local retrobulbar anesthesia of the optic nerve is performed with a hypodermic needle 20 G, 70mm, or with a flexible catheter pushed through a Tuohy epidural needle. The local anesthetic agents cause analgesia extending to the anterior ocular parts, including cornea and conjunctiva. Furthermore, a total akinesia of the globe and a sensory block of the optical nerve are induced, with a reversible loss of vision. Unlike in humans, there are only few blood vessels near the injection site in horses. This was approved by initial examinations with ultrasound (including colour flow Doppler), computed tomography, and anatomical preparation. No serious hemorrhage or other complications hazardous to vision or life could be seen. Ocular surgery in the standing horse with selective nerve blocks is indicated in all horses classified as high-risk patients, especially in geriatric horses. Meanwhile there are several surgical procedures that can be performed with the same accuracy and quality as under general anesthesia, besides the established enucleation. The long-lasting analgesic effect after pre-surgical administration, which is far longer than the pharmacological effect, is an additional benefit of local retrobulbar anesthesia.

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Transpalpebral Eye Enucleation in 40 Standing Horses

Abstract: Enucleating an equine eye in the standing position eliminates the risks and costs of general anesthesia.

Cited by 65 publications

References 7 publications

A retrospective analysis of the risk factors for surgical site infections and long-term follow-up after transpalpebral enucleation in horses

A retrospective analysis of the risk factors for surgical site infections and long-term follow-up after transpalpebral enucleation in horses

Sedation management for standing enucleation of the left eye in a 37 years old horse with decompensated left heart failure

Experiences with the local retrobulbar anesthesia in ophthalmologic surgery of the standing horse

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