Ophthalmology

Medical & Surgical Ophthalmology

Cataract surgery in dogs and cats

Cataracts are the most common cause of vision loss in pets. If not surgically treated, it can lead to numerous complications including inflammation, luxation of the lens, retinal detachment, glaucoma and eventually blindness. Cataract surgery in dogs is performed similarly as in human patients, and it involves phacoemulsification.

Cataract surgery in pets is performed in our hospital.

cataract surgery in dogs
Cataract surgery in a dog

Cataract surgery in humans and pets differs in its preoperative and postoperative course, as well as the surgical procedure itself, which is more complicated compared to standard cataract surgery in human patients.

Cataracts in dogs usually cause a very strong inflammatory reaction in the eye, which is not the case in humans. Before cataract surgery, it is very important to suppress the level of inflammation in the eye with medications, while in some cases, inflammation and rupture of the lens dictate the urgent removal of the cataract in order to save the eye. The findings of preoperative examinations will affect the course of the surgery. Abnormalities in quality or quantity of tear production, the presence of chronic inflammation, the presence of hereditary predisposition to glaucoma (high intraocular pressure), as well as the presence of changes in the posterior segment of the eye are risk factors that must be diagnosed, assessed and adequately addressed before and after cataract surgery to avoid serious postoperative complications.

If the dog already has glaucoma, additional glaucoma surgery must be performed during cataract surgery to establish control of intraocular pressure.

Before the surgery, each patient undergoes regular ultrasound examination of the eye (a test which examines all ocular structures that cannot be seen due to the presence of cataracts, and special attention is paid to the symptoms of retinal detachment), gonioscopy, and high-frequency ultrasound (a method which evaluates drainage system in the eye to assess the risk of developing glaucoma) and an electroretinogram (a test which measures the electrical activity of the retina in the same way that an ECG measures the electrical activity of the heart). After all examinations are done, the owner is given a prognosis on the expected success rate of the surgery, and a decision is made in which manner the surgery should be performed. Postoperatively, the dog’s eye reacts completely differently than the human eye. The dog is carefully monitored after the surgery and the therapy is determined individually. Thanks to these steps, the success rate of cataract surgery is between 90-95% (depending on the dog breed, type of cataract, duration of the disease itself…)

Appearance of the eye immediately after cataract surgery
Appearance of the eye right after the cataract surgery

The surgery itself is performed in the same manner as in humans, except that the lens in dogs and cats is much harder and larger, so ophthalmologists who have had the opportunity to observe cataract surgery in dogs and cats often compare this type of surgery with the most complicated cataract surgeries in human patients.

Cataract surgery is done by insertion of a small, pulsating probe into the eye (lens), causing cataract destruction. After the cataract is destroyed and removed by “suction”, an artificial lens is placed in the eye. Emergency cataract surgery is sometimes necessary, especially in patients with diabetes (because acute cataract swelling with secondary glaucoma and uncontrolled inflammation is possible), or in traumatic lens injuries. In these situations, cataract surgery saves vision and in some cases saves the eye.

Preparation for cataract surgery and postoperative care

The outcome of cataract surgery depends on the pathological processes in the eye prior to the surgery, the general health status of the patient before surgery, as well as regular postoperative control by careful monitoring of the recovery and timely repair of possible complications that are far more common in pets compared to humans.

A detailed ophthalmological examination is necessary to determine whether the patient is a good candidate for surgery. The possibility of a chronic infection, such as bacterial infections of the teeth, or skin, must be ruled out, as bacteria from teeth and skin can migrate to the eye after the surgery.

Therefore, owners are advised to take the pet for a dental examination and removal of large deposits of dental plaque before cataract surgery (small deposits of dental plaques are usually not a problem). All skin problems of the dog (bacterial or allergic in nature) should be brought under control before the operation or immediately after the operation.

The owner should take the pet to his/hers chosen veterinarian to perform the following analyzes and examinations: blood cell count and biochemistry, urine analysis (physicochemical properties and microbiology) and a general clinical examination with auscultation of the heart. The results of these tests should be emailed to us, and then we can schedule the surgery.

Preoperative protocol

Cataracts must be surgically treated as soon as possible to ensure a good outcome and to avoid possible complications. Sometimes, cataracts require urgent surgical treatment, and we are not in a position to follow the pre-surgical protocol. In all other cases, the protocol before surgery is as follows:

1-3 days prior to the surgery, therapy with different eye drops should be initiated. Also, 1-3 days prior to the surgery, systemic therapy with corticosteroids (or non-steroidal anti-inflammatory drugs in dogs with diabetes) and antibiotics should be initiated.

Surgery and postoperative course

You should take a day off on the day of the surgery. You should bring the dog to the hospital in the morning. You should withdraw the food 12 hours, and water 3 hours before the scheduled surgery (for small breeds of dogs, puppies, and patients with diabetes, you will receive special instructions). You should bring all medications the patient is receiving as well as all the results of tests previously done.

The morning before the surgery, do not give the patient oral medication (medication applied by mouth), you should only apply eye drops. For dogs with diabetes, give half of a dose of insulin. The patient will spend the entire day in the hospital, which means that after the surgery, the patient will spend another 4-6 hours under our supervision. We will call you and let you know when you need to pick up your pet.

Early postoperative period: During the first two weeks of surgery, you should apply eye drops 3-6 times a day and pills twice a day. It is recommended to bring the dog for a recheck once or twice during the first two weeks after the surgery. From the end of the second to the end of the sixth week postoperatively, we recommend rechecks once a week or once in two weeks. Eye drops therapy applied 2-3 times a day and therapy with pills should be continued.

Later postoperative period: From the second to the sixth month after the surgery, we recommend rechecks once a month or once every two months. Apply eye drops twice a day. From the sixth month after surgery, rechecks are advised twice a year.