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Capsule Cortex Equine Lens Problems Equine Ophthalmology Service University of Florida Nucleus •The lens sits in the patellar fossa of the vitreous. The horse has weak accommodation (< 2.0 D) to maintain a focussed retinal image. Cataracts Post-inflammatory etiologies ??? ERU cataract/synechia Matt Stevens Multifocal lens with horizontal pupil Zones of optical discontinuity Nuclear cataract Immature cataract Morgan horse hereditary nuclear cataract Whip injury Therapy for Uveitic Cataracts Medical: Oral aspirin might delay cataract formation in a few ERU horses 10 mg/kg q24h Surgery: Only chance for vision – Not easy – Client must be educated about the risks and benefits, and must have realistic expectations! healthy foals (Rhodococcus free) and adult horses no uveitis visual impairment the personality to tolerate topical therapy Brisk PLRs and a dazzle indicate a functional retina. US (RDs) ERG (esp Appaloosas) Cataract Patient Criteria ERG: Dark adapt 20 minutes ERG Light Stimulus X US: mature cataract US: posterior lens capsule rupture RD: “seagull” sign Lens fragments lying on retina. “Phaco” Phaco Surgical Procedure • • • • Paralysis with atracurium Scleral tunnel w/cautery CCC Standard SA needle; 15 mm • Horse needle is 23 mm • • • Machines Hylartin-V™ viscoelastic Mean phaco time: 10:05 minutes (range 4:32 – 15:49) Medications Postoperatively Sulfas systemically for 5 days Banamine (+/- omeprazole): several weeks Topical Atropine: 2 weeks Topical antibiotics: 2 weeks Topical Prednisolone acetate: 1-3 months Hospital stay: avg 8 days, range 3-15 days Phacoemulsification. Success rate ~ 83-98% initially in horses. – Declines rapidly with time due to capsuler scarring and persistent uveitis – 49% at one month (OSU) – 44% at one year (TAMU) – 39% at 18 months (UF) Surgery is easiest in foals and yearlings. Complications: corneal ulcers, persistent corneal edema and ulcers, glaucoma, hyphema, and infectious endophthalmitis – Vision is functional but the aphakic horse should be hyperopic “far-sighted” The aphakic equine globe is +9.9 D hyperopic (20/1200). – A 25 D IOL = +8.0 D IOL Intraocular Lenses (IOLs) in Horses Knotty06 Lens Luxation in Horses Anterior lens luxation Aphakic crescent Trauma from cross ties X 4 wks later Lens subluxation Lens Cysts