Postoperative Bilateral Phacoemulsification Outcomes in Dogs Receiving Subconjunctival Triamcinolone With or Without Topical Anti-Inflammatory Therapy (“Dropless” Cataract Surgery) - Abstract
Purpose: To determine if postoperative topical anti-inflammatory therapy (pTAT) affects phacoemulsification outcomes in dogs receiving subconjunctival
triamcinolone (ST).
Methods: Dogs undergoing bilateral phacoemulsification were identified retrospectively. Age, sex, breed, injectable and oral anti-inflammatory therapy,
diabetic status, fibrin formation, follow up times, visual outcomes, glaucoma (IOP > 24mmHg) and need for pTAT rescue therapy if flare present postoperatively
were compared between groups. Statistics were performed for all comparisons (p=0.05).
Results: 626 eyes were included. 525 eyes received pTAT (diclofenac or ketorolac BID and dexamethasone BID) and 101 eyes did not receive pTAT.
All eyes received 4mg ST perioperatively. All dogs received postoperative oral carprofen (diabetics) or prednisone (non-diabetics). There was no significant
difference in age, breed, sex, diabetic status, fibrin formation or follow up times between groups. In all eyes, the odds of glaucoma were 70% higher and the
odds of vision were 78% lower with pTAT. In diabetics, the odds of glaucoma were 39% lower and the odds of vision were 70% higher than non-diabetics. In
non-diabetic eyes, the odds of glaucoma were 240% higher and the odds of vision were 93% lower with pTAT. 40/101 (40%) of eyes needed rescue pTAT.
Conclusions: pTAT after phacoemulsification increased the risk of glaucoma and blindness in non-diabetic eyes, but did not affect these factors in diabetic
eyes. ST without pTAT (“dropless” cataract surgery) is safe and may control post-phacoemulsification uveitis. Further work is needed to determine the effect of
diabetic status on the risk of glaucoma and blindness. None.