Cataract Surgery

[montall]

Effie (the black one in my signature) is booked in for cataract surgery next Tuesday. She has gone blind rather suddenly in her left eye. It surprises me that a full cataract could grow so quickly that we didn't notice it until a couple of weeks ago. I would have been prepared to swear it grew overnight but for the fact that in certain lights it wasn't so noticeable, but even so it can't have been there for more than a few days.

The eye specialist says that there is a 70 to 75 percent chance the other eye will go the same way so we agreed to the surgery. She is only seven years old and if the other eye goes when she is older (and maybe not a candidate for surgery) at least she will hopefully still have one good eye. They will be totally replacing the lens with a plastic one.

So .. I was wondering if anyone else has had this kind of problem, fast growing cataracts, and if they had surgery how it all turned out. The specialist reckons it is genetic, but I'm not sure I fully believe that, surely a genetic problem would manifest itself before the age of seven. I hope for the sake of all the people who have her puppies and her puppies puppies he is wrong.

[Staranais]

I haven't had the problem in any of my dogs, but have just spent a few days trailing an eye surgeon specialist around, so will be really interested to hear how the operation goes for you. Please let us know how it goes! I have heard of lens removal in cataract surgery, but not lens replacement, it sounds like an amazing advancement.

Also, many genetic health issues can manifest in middle age or old age. Genes switch on and off at the body at different times depending on the age of the animal & the environment it is exposed to. Think of things like male pattern baldness, osteoarthritis, type 2 diabetes, bloat in dogs - there is definitely a genetic component to all of these things, even though they may not manifest until middle age or later.

Late onset cataracts are the same. My understanding is that there's often a primary eye problem such as glaucoma that triggers the development of late-onset cataracts in dogs, but that the genetic predisposition is inherited (so in other words, a dog without the inherited predisposition would not have produced cataracts as a result of the primary eye problem).

I hope it all works out well for you!

[montall]

Thanks Staranais. It's a bit of a mystery as to what triggered the cataract, no sign of glaucoma and the vet that I saw before going to the specialist tested for diabetes (that was his first thought) but the blood test was negative. I think that's why the specialist just said the cause was bad genes from the parents and that it is something that is in the breed. Obviously he's seen it before in the breed, but he made the point that you can get into just as much trouble with a mutt. So no breed bashing from him.

[montall]

Effie is home from her surgery and all went well, the only casualty is our credit card. Her eye is a bit squinty and runny but they assure me that will go in a couple of days. She has to have drops put in her eye four times a day for the next week, then the tablet regime will lessen. Her eye looks perfectly normal, (apart from the squintiness and runiness ) nothing to suggest she now has a plastic lens. Both eyes look the same. I am assured she now has perfect vision but given that she still had one eye working we haven't at this stage noticed a difference.

[Staranais]

Effie is home from her surgery and all went well, the only casualty is our credit card. Her eye is a bit squinty and runny but they assure me that will go in a couple of days. She has to have drops put in her eye four times a day for the next week, then the tablet regime will lessen. Her eye looks perfectly normal, (apart from the squintiness and runiness ) nothing to suggest she now has a plastic lens. Both eyes look the same. I am assured she now has perfect vision but given that she still had one eye working we haven't at this stage noticed a difference.

How amazing to be able to do things like that for a dog (or even a human, for that matter, I guess).

I'm glad it went well for her! ;)

Do you mind me asking how much it was, and how much it would have been to just get the old lens removed & not replaced with anything (if you know, & don't mind answering)?

[montall]

The operation cost a little over $2,500 but some of that was the meds. Not replacing the lens was never discussed so I have no idea what the difference in price would have been but the lens itself cost $800 so that gives you a bit of an idea. There would have been other bits and pieces of equipment used to insert the lens that would also come off the overall price if the lens wasn't replaced. The invoice is fully itemised but I don't know what bits would be purely for the lens insertion. The technology involved is exactly the same as is used in human surgery. They cut a very small incision in the eye and use some tool (a laser I think he said) to break the old lens up and sort of siphon it out, so they don't need a big incision. Then they pop the artificial lens into place with some special injector tool. Apparently it goes in sort of folded up really small and springs out into shape after it has been inserted. There is very little pain involved and with humans there isn't even any need for a anaesthetic, but it is better to knock an animal out because it would be difficult to keep them perfectly still.

I'm curious about not replacing the lens, surely that would mean the animal would still be blind. Is that done just to avoid ulcers or further damage to the eye? The specialist did say that if cataracts are left untreated long enough they can damage the eye to the point where nothing can be done to restore sight. Effie's eye was a little inflamed before the surgery and she needed drops for a fortnight before they could do the op, and he said that would have been caused by the cataract, so they obviously can do even more damage than just cause the loss of sight.

Edited to add a bit more information.

Edited December 14, 2010 by montall

[Staranais]

Thanks so much, that's really interesting.

I'm curious about not replacing the lens, surely that would mean the animal would still be blind. Is that done just to avoid ulcers or further damage to the eye? The specialist did say that if cataracts are left untreated long enough they can damage the eye to the point where nothing can be done to restore sight. Effie's eye was a little inflamed before the surgery and she needed drops for a fortnight before they could do the op, and he said that would have been caused by the cataract, so they obviously can do even more damage than just cause the loss of sight.

I asked the specialist that very thing last week, since we were talking cataracts, and he reckoned that removing the lens should restore most sight to the animal, although they wouldn't be able to focus on things very well. He said they should at least get enough vision so as to not bump into things when they run around, which is a huge advantage to an animal that was blind or nearly before.

If the cataract is left there I think it can cause inflammation in the retina (uveitis) & the animal possibly could cause loss of sight that way?

We have another day or so with the specialist later in the year I think, I'm going to ask him about lens replacement & if we can do it here.

[vetrg]

Lens replacement with a false lens is usually done if possible after lens extraction as it will allow focus for the animal. The replacement lens gives fixed distant focus, just like with people (humans after cataract surgery will still require reading glasses). Distance vision is considered greater than 6 feet away. The dog can still see things closer up, they are just a bit blurry.

Dog can still have useful vision if a lens is not placed as they dont have to read/ drive a car etc. Sometimes it is not possible to place a false lens however but ideally a lens is placed at it helps prevent scarring of the remaining lens capsule.

Good luck with the surgery and post op care.