Section: Veterinary Care In-depth
Treatment In-depth
Treatments for cataracts may include one or more of the following:
Cataract surgery. At the present time, there is no laser surgery for removing cataracts in either people or animals. Phacoemulsification is the most common technique used in both humans and animals to remove a cataract. Once the pupils have been dilated and your pet is under general anesthesia, a small incision is made through the cornea (clear domed front surface of the eye). The lens is housed in a small bag called the lens capsule. A small tear is made in the front capsule and a circular piece of the capsule is removed. The phacoemulsification instrument uses ultrasonic waves to break apart the lens and then suck it out. Most of the lens is removed by phacoemulsification, and then the lens capsule (the "bag") is cleaned of any remaining lens material. Frequently an intraocular lens implant (a prosthetic lens) is then placed into the lens capsule.
The lens capsule acts as a bag to hold the implant in place. There are lens implants for both dogs and cats, and these prosthetic lenses return the vision as close to normal as possible. There are some situations where a lens cannot be inserted. When no lens implant is used, an animal's vision is still greatly improved by cataract surgery.
The incision through the cornea is then stitched closed after the lens has been removed.
Extracapsular lens extraction. This is another cataract removal technique. It is used either when a phacoemulsification machine is not available, or when a cataract is so hard or old that the phacoemulsification instrument isn't powerful enough to break up and remove the lens. The surgical procedure requires making a larger incision through the cornea and a larger hole in the lens capsule so that the lens can be removed from the bag as a whole. A lens implant can still frequently be inserted during this type of procedure.
Intracapsular lens extraction. This is another surgical method that involves making a large incision through the cornea and removing the whole lens in its capsule. This procedure is generally used when a cataractous lens has shifted out of position and is no longer held firmly in place inside of the eye. Because the lens capsule has been removed, if a lens implant is going to be used, it has to be sewn into place because there is no capsular bag left to hold it in the center of the eye.
Regardless of which type of procedure is used to remove a cataractous lens, there are many postoperative medications and important home care instructions to be followed after surgery.
Surgical Complications
Cataract surgery has a high success rate, as long as the rest of the eye is healthy. The success rate of cataract surgery is decreased if the eye has been inflamed in the past, or is actively inflamed. All uveitis must be controlled before cataract surgery can be attempted, and other eye problems such as retinal disease and glaucoma must also be ruled out.
Risks involved with cataract surgery include those associated with general anesthesia. Anesthetic risks are minimized by evaluating pre-operative laboratory tests, performing a complete physical exam, and taking x-rays of the chest. The information gathered from these tests is then used to develop an appropriate anesthetic protocol.
Anterior uveitis and glaucoma are the two most immediate and common complications encountered in the days following cataract surgery. Many dogs are medicated prior to surgery to combat the uveitis that occurs once the eye is opened, and these medications are continued for weeks following the surgery. Pressure within the eye is monitored closely following surgery, and anti-glaucoma drugs are started as needed.
The most common problems that arise long-term after cataract surgery are scarring of the lens capsule that remains in the eye and detachment of the retina. Because of both short-term and long-term problems that may be encountered after cataract surgery, frequent follow-up visits are needed for sometime.
Non-Surgical Cataracts
If your pet's cataracts are secondary to some other eye disease, removal of the cataract is frequently contraindicated.
Medical therapy may be necessary to control inflammation within the eye, to combat any glaucoma present, and to treat underlying illnesses, even when the cataract cannot be removed. Periodic follow-up examinations are required to keep the eye healthy and the cat comfortable.
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