Combined transscleral diode laser cyclophotocoagulation and Ahmed gonioimplantation in dogs with primary glaucoma: 51 cases (1996–2004)

Authors

  • John S. Sapienza,

    Corresponding author
    1. Long Island Veterinary Specialists, 163 South Service Road, Plainview, NY 11803, USA;
      Address communication to: John Sapienza Tel.: (515) 501-1700 Fax: (516) 501-1169 e-mail: JSAPEYE@AOL.com
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  • Alexandra Van Der Woerdt

    1. The Animal Medical Center, New York, USA
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Address communication to: John Sapienza Tel.: (515) 501-1700 Fax: (516) 501-1169 e-mail: JSAPEYE@AOL.com

Abstract

Objective  To evaluate the combined diode laser cycloablation procedure and adjunctive Ahmed gonioimplant use in dogs with primary glaucoma.

Design  Retrospective study.

Animals  48 dogs, 51 eyes with primary glaucoma.

Procedure Medical records from two large private clinical ophthalmology services were reviewed. Signalment, duration of glaucoma, gonioscopic evaluation, laser power and duration settings, immediate postoperative and final intraocular pressure and visual results, short and long-term visual outcome, and surgical complications were recorded.

Results  The age range of affected dogs was 3.0–14.0 years, with a mean age of 7.5 ± 2.6 years. Eleven pure breeds were represented, with the most common being the American Cocker Spaniel. The sex distribution was 22 neutered males, 1 intact male, 23 spayed females, and 2 intact female dogs. The right eye was affected in 33 cases, and the left eye in 18 cases. The average total joules, which was administered with the diode laser, was 109.6 ± 23.6 J.

 Immediate surgical complications included fibrin formation in the anterior chamber (15), corneal ulcers (4), hyphema (7), and focal retinal detachment (1). Long-term complications included cataract formation (8 total, 2 of which were significant, vision-threatening), elevated intraocular pressure (IOP) (6), unstable gonioimplant (1), and glaucoma recurrence (14). Additional surgeries performed on the eyes over the course of study included: intrascleral prosthesis (4), enucleation (1), resection of fibrotic scar tissue (5), and repeat laser cycloablation (8). The dogs were examined for a mean follow-up time of 17.6 months (range: 2–83 months postoperatively). Twenty-nine cases were followed greater than one year. Vision was maintained in 42/51 eyes (82%) in the immediate short-term of this study.

 In all cases included in the study, good control of IOP was achieved in 39/51 (76%) of eyes, and IOP was poor or uncontrolled in 12/51 (24%) of eyes. Twenty out of 41 eyes (49%) maintained fair to excellent vision six months after surgery. Twelve months postoperative observations demonstrated that 12/29 (41%) of the eyes were still visual.

Conclusions  In primary glaucoma, the combined procedure of laser diode cyclophotocoagulation and Ahmed valve implant was associated with return or maintenance of vision in 42/51 eyes (82%) in the immediate short-term of this study, and a long-term IOP control in 39/51 (76%) of the cases, with 12/29 eyes (41%) visual after 12 months.

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