Cataract removal is an elective procedure that we can offer patients whose vision is affected by their cataracts. It can restore eyesight and often dramatically improves the quality of life in pets who no longer play or engage because they are visually limited. The excitement level in owners when they hear that their pet may be able to see a squirrel again or bark at the car in the driveway is palpable.
Although an elective procedure, there can be risks associated with cataract surgery and this is why your role in the patient selection process can be pivotal. There are several steps that are required to get a patient ready for surgery and many that can be carried out in your hospital.
Ensure the patient is systemically stable
For the best possible prognosis following surgery, it is important that patients are systemically stable prior to the procedure. Many of these patients tend to be older and can have other systemic diseases present. Therefore a complete physical examination and minimum data base of CBC, serum chemistry profile and urinalysis should be performed prior to surgery. If the patient is diabetic, a recent blood glucose curve or fructosamine level showing at least fair control of their diabetes is recommended. Ideally, this lab work should be completed within one month of the surgery date.
Eliminate any concurrent infections
Eyes are prone to becoming seeded with infection from other parts of the body and endophthalmitis can be a devastating complication. Therefore, we strive to eliminate ALL infections anywhere in the body (skin, mouth, urinary tract, etc) prior to surgery.
Skin infection – If there are any skin infections (dermatitis, pododermatitis, otitis, etc.), it is important to aggressively treat and eliminate these infections. With patients who have chronic infections from allergies that are difficult to permanently eliminate, the patient should be ON antibiotics/antifungals for 1-2 weeks prior to surgery to minimize the burden at the time of surgery.
Oral Exam – Any moderate to severe periodontal disease should be treated prior to cataract surgery. In general we feel comfortable with a 2 week wait time between the dental procedure and cataract surgery.
Urinalysis – A urinalysis should be performed on all cataract patients to rule out the possibility of urinary tract infection.
Begin preoperative medications
• Starting an anti-inflammatory drop as soon as cataracts are diagnosed will help to minimize the inflammation associated with cataracts and improve the post-operative outcome. A medication we commonly use is Flurbiprofen Ophthalmic, 1 drop in the affected eye BID until surgery.
These steps should be completed prior to surgery, and they can be completed either at your practice or at UVS depending on what you and your client determine to be best. In general, if a pet owner is strongly considering cataract surgery for their pet we do recommend referral sooner rather than later as early intervention has been shown to result in less pre and post-operative complications.
If you have any questions about cataract surgery in dogs and cats, or any other ophthalmic concerns, please do not hesitate to contact Dr. Diana Pate or Dr. Sony Kuhn via email at firstname.lastname@example.org or phone at 864-233-7650.