Ocular Surgery

Ocular Surgery


Standing



Basic Information image



Synonym(s)




Ocular surgery without general anesthesia in the horse



Overview and Goal(s)




• There are many advantages to performing standing surgical procedures and avoiding general anesthesia in horses.


image Horses with orthopedic or other medical problems may be at higher risk to develop anesthesia-related complications and should not undergo routine general anesthesia.

image Even healthy horses can injure themselves on recovery from general anesthesia and are predisposed to develop colic, cecal impactions, and myositis in the postanesthetic period.

image Standing surgical procedures can also decrease the time needed for hospitalization compared to horses receiving general anesthesia. This is advantageous because hospitalized horses, in general, are predisposed to developing pneumonia, laminitis, salmonellosis or other forms of colitis, and laminitis.

image Therefore learning the correct and latest methods for performing standing ocular surgery will increase a veterinarian’s ability to provide excellent service without a major outlay of infrastructure expense.

• Because the cornea and conjunctiva of the horse’s eye are thin and delicate, ophthalmic surgery must be precise to avoid damage.


image The use of small instruments, needles, and suture is generally required.

image In most instances, the surgeon will benefit from the use of magnification, which allows precise cutting of tissues and suture placement but exaggerates patient movement when the horse is not anesthetized.

image To perform ocular microsurgery, the eye must be immobile. In general, the use of microsurgical technique and magnification during equine ocular surgery requires general anesthesia. However, with appropriate tranquilization, ocular nerve blocks (especially the retrobulbar nerve block) and restraint, many ocular surgeries can be performed adequately in standing horses.

image The purpose of this chapter is to describe the equipment needed and technique for performing ocular surgical procedures in the standing horse.


Indications


Surgical procedures that can be done with the horse standing include those involving the eyelids, conjunctiva, and cornea (tumor removal, keratectomy, eyelid laceration, third eyelid removal) that take less than 30 minutes to perform). Also, minimally invasive intraocular procedures such as iris cyst laser disruption, laser cyclophotocoagulation, or anterior chamber centesis can be performed adequately with the horse standing.



Contraindications


Surgeries for perforating lesions of the cornea (or lesions pending perforation, such as corneal descemetoceles or infected deep corneal ulcers) or intraocular surgical procedures such as cataract surgery



Equipment, Anesthesia




• Lidocaine HCL (2.0%) or mepivacaine HCL (2.0%) (or similar medication)


• 25-gauge needles


• 3-mL syringes


• 22-gauge 2.5-inch spinal needle


• 1% Proparacaine HCL

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Jul 24, 2016 | Posted by in SMALL ANIMAL | Comments Off on Ocular Surgery

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