Veterinary Ophthalmic Surgery

Front Cover
Veterinary Ophthalmic Surgery
Copyright Page
Contents
Contributors
Acknowledgments
Preface
I. Essentials
1 Surgical Instrumentation
Introduction
Design of Ophthalmic Instruments
Ophthalmic Surgical Instruments
Eyelid Specula
Tissue Forceps
Eyelid/Chalazion Forceps
Conjunctival Forceps
Corneal, Limbal, and Scleral Forceps
Suture and Tying Forceps
Iris Forceps
Anterior Lens Capsule Forceps
IOL Instrumentation
Intraocular Forceps
Scissors
Conjunctival Scissors
Corneal Scissors
Corneoscleral or Corneal Section Cataract Scissors
Iris Scissors
Intraocular Scissors
Instruments Used During Phacoemulsification
Knives
Needle Holders
Spatulas/Retractors/Loops
Cannulae for Intraocular Injections
Calipers
Rings
Adaptations for Large Animal and Special Species Ophthalmic Surgeries
Surgical Instruments for Ophthalmic Surgeries
Recommended Instruments for Orbital Surgeries
Recommended Surgical Instruments for Eyelid Surgeries
Recommended Surgical Instruments for Conjunctival and Corneal Surgeries
Recommended Surgical Instruments for Intraocular Surgeries and Cataract Extractions
Instruments for Vitreoretinal Surgeries
Ophthalmic Sutures and Needles
Instrument Care, Storage, and Sterilization
Further Reading
2 The Operating Room
Introduction
Magnification
Head-Mounted Magnifiers
Head Loupes
Operating Microscopes
Operating Microscope Components
Mounting Systems
Illumination
Optical System
Recording Equipment
XY Systems
Microscope Focusing
Fogging Eyepieces
Corneal Drying and Retinal Phototoxicity
Illumination
Chairs for Ophthalmic Surgery
Patient Preparation
Clipping of Hair and Eye Protection
Cleansing and Disinfection
Patient Positioning
Surgeon Positioning
Draping
Irrigation
Sponges/Swabs
Basic Operative Approach
Stay Sutures
Flieringa or FlierinGa–LeGrand Fixation Rings
Lateral Canthotomy
General Anesthesia/Neuromuscular Blocking Agents
Problems with Enophthalmia
Retrobulbar Injections
Hemostasis
Local Epinephrine
Electrocautery
Electroepilation
Cryotherapy
Laser Therapy
Laser Basics
Laser Delivery
Laser Choice
Laser Applications
Laser Safety
Perioperative Drugs
Viscoelastics
Postsurgical Consideration
Patient Recovery/Restraint
Subpalpebral Lavage Systems
Further Reading
3 Anesthesia for Ophthalmic Surgery
Introduction
Role of General Anesthesia
Ophthalmic Effects of General Anesthetics
Intraocular Pressure
Corneal Drying and Exposure
Oculorespiratory Cardiac Reflex
Eye Position
Pupil Size
Extraocular Muscular Tone
Indications for and Effects of Sedation
Effects of Preanesthetic Medications
Effects of Injectable General Anesthetics
Effects of Inhalational Anesthetics
Neuromuscular Blocking Agents
Ophthalmic Drug and Anesthetic Drug Interactions
Systemic Diseases and General Anesthesia
Local or Regional Eyelid Injections/Nerve Blocks
Eyelid Injections/Nerve Blocks in the Dog and Cat
Eyelid Injections/Nerve Blocks in the Horse
Eyelid Injections/Nerve Blocks in the Cow
Retrobulbar Injections/Nerve Blocks in Animals
Retrobulbar Injections/Nerve Blocks in Dogs
Retrobulbar Injections/Nerve Blocks in Cats
Retrobulbar Injections/Nerve Blocks in Horses
Retrobulbar Injections/Nerve Blocks in Cattle
Complications of Retrobulbar Injections/Nerve Blocks
Considerations for General Anesthesia for Selected Ophthalmic Surgical Procedures in Different Species
Orbital Surgery
Eyelid Surgery
Nasolacrimal Flush and Catheterization
Conjunctival and Nictitating Membrane Surgeries
Corneal and Intraocular Surgeries
Recovery from General Anesthesia
Adaptations for Large Animals and Special Species
Horse
Cattle
Further Reading
4 Principles of Microsurgery
Introduction
Principles of Wound Closure
Instrument Handling
Incisions
Handling Tissues During Incision
Tissue Chatter
Ophthalmic Sutures and Needles
Sutures
Suture Needles
Suture Placement and Technique
Knot Tying Principles and Techniques
Closure of Corneal Wounds
Suture Pattern
Selected References
II. Small Animal (Dog & Cat) Ophthalmic
5 Surgery of the Orbit
Introduction
Defining the Margins of Orbital Disease
Strabismus and Orbital Diseases
Strabismus (Rectus Muscle) Surgery
Ancillary Diagnostic Procedures
Incomplete Lateral Orbital Walls in Canine and Feline
Enophthalmia and Surgery
Surgical Anatomy
Canine Orbit
Feline Orbit
Surgical Pathophysiology
Effect of Globe Development on Orbit Growth
Traumatic Proptosis/Avulsion/Luxation of the Globe
Orbital Fractures
Orbital Inflammations: Acute and Chronic
Orbital Neoplasms
Perioperative Medications
Types of Orbital Surgical Procedures
Enucleation Procedures in Small Animals
Subconjunctival Enucleation
Transpalpebral (‘En Bloc’) Enucleation
Lateral Enucleation
Evisceration with Intraocular Prosthesis in Small Animals
Exenteration
Berggren–Håkansson Exenteration Procedure
Removal of Prolapsed Retrobulbar Fat
Orbitotomy in Small Animals
Indications for Orbitotomy
Lateral Orbitotomy
Dorsal Orbitotomy
Anterior (or Transfrontal) Orbitotomy
Transoral Orbitotomy
Total and Partial Orbitectomy
Orbital Fracture Repair
Surgical Management of Traumatic Proptosis in Small Animals
Surgical Augmentation of Orbital Volume in Small Animals
Postoperative Care and Management
Postoperative Complications and Treatment
Enucleation
Evisceration
Exenteration
Orbitotomy
Posttraumatic Proptosis
Short- and Long-Term Results
Enucleation
Evisceration
Exenteration
Orbitotomy
Traumatic Proptosis
Further Reading
6 Surgery of the Eyelids
Introduction
Diseases of the Canine and Feline Eyelids
Adaptations from Eyelid Surgeries in humans
Anatomy
Eyelid Skin, Cilia (Eyelashes), and Glands
Eyelid Muscles
Eyelid Tarsal Layer and Glands
Palpebral Conjunctiva
Eyelid Sensation
Eyelid Innervation
Eyelid Blood Supply and Lymphatics
Eyelid Function
Preoperative Examination Diagnostics
Surgical Considerations
Surgical Instrumentation
Surgical Preparations of the Eyelids
Tarsorrhaphy
Permanent Tarsorrhaphy
Temporary Tarsorrhaphy
Postoperative Care and Complications after Tarsorrhaphy
Lateral Canthotomy
Surgeries for Eyelid Agenesis
Roberts and Bistner Procedure
Dziezyc and Millichamp Procedure
Modified Lip-to-Lid Procedure
Postoperative Management and Complications of Myocutaneous Pedicle Grafts
Surgeries for Distichiasis
Postoperative Management and Complications after Distichia Surgery
Surgical Procedures for Ectopic Cilia
Surgeries for Entropion
Nonsurgical Treatment of Entropion
Temporary eversion: “tacking”
Quikert–Rathbun Procedure
Surgical Management of Entropion
Hotz–Celsus Procedure for Entropion
Modification of Hotz–Celsus Technique for Medial Entropion
Bigelbach Modification for Medial Entropion
Modification of the Hotz–Celsus Method for Lateral Canthal Entropion
‘Y’ to ‘V’ Plasty for Entropion
Central Tarsal Pedicle for Entropion (Wyman)
Combined Entropion–Distichiasis Procedure
Stades Combined Entropion–Trichiasis Procedure
Modified Hotz–Celsus Procedure for Entropion and Ectropion
Face Lift/Skinfold Excision and Rhytidectomy
Modified Brow Suspension Technique
Surgeries for Lateral Canthal Entropion in Large Breeds
Arrowhead Procedure for Lateral Canthal Entropion
Lateral Canthoplasty by Wyman
Lateral Canthoplasty with Suture
Robertson’s Lateral Canthal Tendonectomy
Postoperative Management and Complications
Surgical Procedures for Ectropion
Lateral Eyelid Wedge Excision
‘V’ to Y’ Plasty (Wharton–Jones Procedure)
Kuhnt–Szymanowski Procedure
Modified Kuhnt–Helmbold Procedure
Modified Kuhnt–Szymanowski Procedure (Munger and Carter)
Postoperative Management and Complications
Surgeries for Combined Ectropion and Entropion
Bigelbach’s Lateral Tarsorrhaphy-Canthoplasty
Bedford’s Modification of the Kuhnt–Szymanowski Technique
Grussendorf Procedure
Surgeries to Reduce Palpebral Fissure Size
Medial Canthoplasty
Pocket Technique (Roberts and Jensen)
Lateral Reduction Canthoplasty
Lateral Canthoplasty (Fuchs)
Lateral Canthoplasty (Wyman and Kaswan)
Surgeries to Increase Palpebral Fissure Size
Lateral Augmentation Canthotomy
Arrowhead Procedure for Entropion with Lateral Canthotomy
Nasal Fold Trichiasis and Resection in Dogs
Surgical Treatment of Chalazion
Surgical Repair of Eyelid Lacerations
Surgeries for Minor Eyelid Neoplasms
Partial Thickness Lid Excision of Eyelid Masses
‘V’ Full-Thickness Excision
Four-Sided Full-Thickness Excision
Postoperative Management and Complications
Reconstructive Blepharoplasty
Sliding Skin Graft
‘Z’ Plasty Skin Flap
Semicircular Skin Grafts
Sliding Skin Flaps Combined with Tarsoconjunctival Grafts
Full-Thickness Lid Grafts (Bucket-Handle or Cutler–Beard Method)
Large Pedicle Skin or Skin-Muscle Grafts
Postoperative Management and Complications
Further Reading
7 Surgery of Nasolacrimal Apparatus and Tear Systems
Introduction
Nasolacrimal Apparatus
Surgical Anatomy
Diagnostics for the Nasolacrimal Drainage Apparatus
Nasolacrimal Catheterization or Stenting
Surgical Procedures for the Nasolacrimal Apparatus
Surgery for Imperforate Lacrimal Punctum
Enlargement of the Lower Lacrimal Punctum
Displacement of the Lower Lacrimal Punctum
Lacerations of the Canaliculi
Dacryocystotomy
Conjunctivorhinostomy (Caudal Nasal Cavity)
Conjunctival Maxillary Sinusotomy (Into The Maxillary Sinus)
Conjunctivobuccostomy
Surgical Approaches to Dacryops
Surgery for Keratoconjunctivitis Sicca
Surgical Anatomy
Treatment of Acute Keratoconjunctivitis Sicca
Surgical Treatment of Medical Refractory Chronic Keratoconjunctivitis Sicca by Parotid Duct Transposition In Dogs and Cats
Surgical Procedure
Oral Approach for Parotid Duct Transposition in Dogs
Postoperative Management and Results
Results of Parotid Duct Transposition
Postoperative Complications
Further Reading
8 Surgical Procedures for the Conjunctiva and the Nictitating Membrane
Introduction
Conjunctival Anatomy
Anatomy of the Nictitans
Bulbar/Palpebral Conjunctival Biopsy (Punch/Snip)
Surgical Repair of Conjunctival Lacerations
Surgical Repair of Conjunctival Defects
Surgical Treatment for Symblepharon
Conjunctival Grafts/Transplantation
Conjunctiva Autografts
Conjunctiva to Conjunctiva
Buccal Mucosa Autografts to Conjunctiva
ConjunctivaL Autografts to Cornea
Complete (360° or Gundersen-type) Bulbar Conjunctival Graft
Modified Complete (360°) Bulbar Conjunctival Graft with Two Suture Lines
Advancement (Hood or 180°) Bulbar Conjunctival Grafts
Bridge Bulbar Conjunctival Grafts
Pedicle Bulbar Conjunctival Grafts
Pedicle Tarsopalpebral Conjunctival Grafts
Island Transpalpebral Conjunctival Grafts
Corneoconjunctival Autograft/Transposition
Postoperative Patient Management, Success Rates, and Potential Complications
Permanent Conjunctival Grafts
Substitute Materials for Conjunctival Grafts
Porcine Small Intestinal Submucosa (SIS) Grafts
Amniotic Grafts as Conjunctival Substitutes
Other Tissues for Conjunctival Substitutes
Surgeries of the Nictitans
Surgical Treatment of Everted Nictitans
Surgical Treatment for Hyperplastic Lymphoid Follicles
Surgical Procedures for Protrusion of the Gland of the Nictitating Membrane or “Cherry Eye”
Posterior (Bulbar) Nictitans Anchoring Approach
Anterior Nictitans (Palpebral) Anchoring Approach
Intranictitans Tacking Procedure
Conjunctival Mucosa Envelope Procedure
Conjunctival Mucosa Pocket Procedure
Postoperative Results and Complications
Surgical Procedures for Prominent/Protruded Nictitans
Nictitating Membrane Flaps
Nictitating Membrane Flap: Conjunctival Fornix
Nictitating Membrane Flap: Blogg and Helper Modification
Nictitating Membrane Flap: Episcleral Fixation
Postoperative Management and Complications
Partial/Complete Excision of the Nictitans
Further Reading
9 Surgery of the Cornea and Sclera
Introduction
Surgical Anatomy
Pathophysiology
Perioperative Treatment
Surgical Instrumentation
Surgical Procedures for Superficial Corneal Diseases
Superficial Keratectomy (Partial and Complete)
Postoperative Complications
Superficial Punctate, Grid, and Linear Keratotomies
Superficial Punctate Keratotomy
Superficial Grid Keratotomy
Diamond Burr Debridement
Corneal Biopsy
Surgical Procedures for Deep Corneal Ulcerations
Primary Closure of Small, Deep Corneal Ulcers
Conjunctival Autografts
Corneoscleral and Corneoconjunctival Transpositions
Biomaterial Grafts for Corneal Diseases
Biosynthetic Collagen Grafts
Amniotic Membrane Grafts
Corneal Adhesives
Surgery for Corneal Lacerations
Preoperative Medical Treatment
Partial-Thickness Corneal Lacerations
Penetrating Corneal Lacerations With or Without IRIS Prolapse
Penetrating Corneal Lacerations and Anterior Lens Capsule Tears With or Without IRIS Prolapse
Surgery for Corneal Foreign Bodies
Corneal Grafts/Keratoplasty
Preparation of Donor Corneas
Instrumentation for Keratoplasties
Indications for Keratoplasty
Preoperative Treatment
Preparation of Corneal Donor Graft
Autogenous Sliding Lamellar Grafts
Homologous Lamellar Corneal Grafts
Autogenous Rotating Full-Thickness Corneal Grafts
Homologous Full-Thickness/Penetrating Corneal Grafts
Frozen (Tectonic) Corneal Grafts
Heterologous Corneal Grafts in Small Animals
Descemet’s Stripping Endothelial Keratoplasty
Thermokeratoplasty
Surgical Treatment of Limbal and Scleral Diseases
Local Excision with Partial-Thickness Scleral Excision
Preparation of Scleral Donor Material
Excision of Limbal Melanoma with Full-Thickness Scleral Homograft
Postoperative Management and Results
Laser Treatment of Limbal Melanomas
Further Reading
10 Surgical Procedures of the Anterior Chamber and Anterior Uvea
Introduction
Surgical Anatomy
Limbus
IRIS
Ciliary Body
Iridocorneal Angle
Pathophysiology
Perioperative Considerations
Surgery of the Anterior Chamber
Aqueocentesis/Anterior Chamber Paracentesis
Corneal/Limbal Incisions
Surgical Treatment of Hypopyon, Hyphema, and Anterior Chamber Foreign Body or Parasites
Surgery for Hypopyon
Surgical Removal/Aspiration
Surgery for Hyphema
Enzymatic Therapy for Hyphema
Anterior Chamber Foreign Body and Parasites
Postoperative Management and Complications
Surgical Procedures of the Anterior Uvea
Iridotomy
Sphincterotomy
Coreoplasty
Sectoral Iridectomy/Iridal Biopsy
Surgical Treatment of IRIS Bombé
Iridocyclectomy/Iridociliary Biopsy
Laser Treatment of Anterior Uveal Cysts
Laser Treatment of Anterior Uveal Neoplasms
Further Reading
11 Surgical Procedures for the Glaucomas
Introduction
Canine Glaucomas
Feline Glaucomas
Diagnostic and Monitoring Techniques
Glaucoma Classification as a Guide To Therapy
Medical and/or Surgical Treatment
Surgical Anatomy
Preoperative Treatment
Surgical Procedures for the Glaucomas
Historical Glaucoma Surgeries in Humans and Dogs
Aqueous Humor Filtering Procedures
Anterior Chamber Shunts/Gonioimplants
Progression of Implant Design
Valved vs. Nonvalved Systems
Size of the Implant
Shape of the Implant
Size of the Anterior Chamber Tubing
Biocompatibility of Implant Material
Position of the Implant’s Episcleral Base
Wound Healing after Glaucoma Filtration Surgery
Shunts to Other Areas
Surgical Procedures for Anterior Chamber Shunts
Anterior Chamber Shunt to the Frontal Sinus
Postoperative Management Following Gonioimplantation
Complications and Results of Anterior Chamber Shunts
Cyclodestructive Procedures
Cyclocryothermy
Transscleral Laser Cyclophotocoagulation
Diode Endoscopic Cyclophotocoagulation
Pharmacological Ablation of the Ciliary Body
Eye Removal
Further Reading
12 Surgical Procedures of the Lens and Cataract
Introduction
Cataract Classifications
Types of Cataracts
History of Cataract Surgery in Dogs
Development of the Intraocular Lens in Animals
Intraocular Lens in the Dog
Intraocular Lens in the Cat
Surgical Anatomy
Normal Lens Anatomy
Surgical Pathophysiology
Patient Selection
Age
Temperament
Concurrent Eye Disease
Maturity of Cataract
Diabetes Mellitus
Unilateral Cataracts
Bilateral Cataract Surgery
Intraocular Pressure
Preoperative Electroretinography and Ultrasonography
Risk for Retinal Detachment in Certain Breeds
Nonsurgical Treatment of Cataracts
Medical Treatment of Cataracts
Spontaneous Cataract Resorption in Young (< 3.0 Years) Dogs
Axial Nonprogressive Cataracts and Long-Term Mydriasis
Secondary Cataracts and Iridocyclitis
Blind Animals
Continued Monitoring of Nonsurgical Cataractous Patients
Preoperative Preparation
Perioperative Medications
Surgical Procedures for Cataracts and Lens Removal
Anterior Chamber Entry for Cataract and Lens Extraction
Peripheral Iridectomies
Capsulorrhexis and Anterior Capsulectomies
Continuous Curvilinear Capsulorhexis
Can-Opener Method
Modifications
Phacoemulsification
Fundamentals of Phacoemulsification
Irrigation and Delivery of Fluids to the Anterior Chamber
Aspiration and Vacuum Levels
Ultrasonic or Cutting System
Ultrasonic Needles
Irrigation-Aspiration Handpiece
Corneal Damage During Phacoemulsification
Fundamental Phacoemulsification Procedures
One- and Two-Handed Phacoemulsification
Phacoemulsification in the Dog
Hydrodissection
Phacoemulsification of the Cataract
Divide-and-Conquer Technique
Chip-and-Flip Technique
Phaco-Chop Technique
Sculpting and Lens Rotation
Intraocular Lens Implantation
Extracapsular Lens Extraction in Small Animals
Intracapsular Cataract or Lens Extraction on Dogs and Cats
Removal of the Unstable Lens in Dogs and Cats
Operative Procedure
Trans-Corneal Reduction
CilIary Sulcus Intraocular Lens Fixation or Placement
Postoperative Treatment and Management
Postoperative Results and Complications
Complications of Cataract Surgery
Intraoperative Complications
Inadequate Exposure
Intraoperative Complications with Intraocular Lenses
Miotic Pupil
Expanding Vitreous Syndrome and Anterior Vitreous Presentation
Aberrant and Radial Capsular Tears
Excessive Fibrin Within the Aqueous Humor
Intraoperative Bacterial Contamination
Anterior and Posterior Capsular Opacities
Short- and Long-Term Complications
Iridocyclitis and Sequela
Corneal Edema
Acute or Transient Ocular Hypertension
Corneal Ulcerations
Bacterial and Sterile Endophthalmitis
Surgical Wound Leakage
Hyphema
Postoperative Glaucoma or Aphakic (Pseudophakic) Glaucoma
Fibropupillary and Inflammatory Membranes/Anterior, Intralenticular, and Posterior Capsular Fibrosis
Intraocular Lens Complications
Retinal Detachment
Further Reading
13 Vitreoretinal Surgery
Introduction
Surgical Anatomy
Surgical Pathophysiology
Role of the Vitreous
Cataract Surgery
Inherited Cataracts and Lens-Induced Uveitis
Inherited Retinal Dysplasia
Predisposed Breeds
Other Factors
Retinal Detachments in Cats
Types of Retinal Detachments
Types of Vitreoretinal Surgeries
Clinical Evaluation of Retinal Detachments
Instrumentation for Vitreoretinal Surgeries
Surgical Instruments
Perfluorocarbon Gases
Silicone Oil (SiO)
Vitreal Aspiration and Removal
Preoperative Considerations for Retinal Detachments
Vitreoretinal Surgeries
Surgery of the Vitreous
Hyalocentesis/Vitreous Paracentesis
Vitreous Aspiration Procedure
Potential Complications After Hyalocentesis
Intravitreal Injections
Transpupillary Vitreal Aspirations
Anterior/Partial Vitrectomy in Dogs
Surgical Procedure
Postoperative Management
Chorioretinal Surgical Procedures
Subretinal Fluid Aspiration
Chorioretinal Biopsy
Postoperative Management
Types of Retinopexy
Pneumatic Retinopexy
Therapeutic Retinopexy
Demarcation and Barrier Retinopexy
Prophylactic Retinopexy
Retinal Detachment Surgery
Patient Selection
Preoperative Medications
Retinal Detachment Surgery with a Retinal Hole or Small Tear
Exposure
Localization of the Retinal Break
Sealing the Retinal Break
When Scleral Buckle Is Used
Removal of Subretinal Fluids
Closure
Postoperative Management
Pars Plana Retinal Detachment Surgery
Intravitreal Gases
Retinal Tacks
Vitreal Bands
Essential Vitreoretinal Instruments
Surgical Procedure
Exposure
Peritomy
Pars Plana Ports
Intrascleral Venous Plexus
Vitrectomy
Retinal Breaks and Tears
Exchange of Silicone for Perfluorocarbon
Closure
Postoperative Management
Postoperative Complications
Postoperative Glaucoma or Late-Onset Glaucoma
Corneal Exposure and Ulceration
Cataract Formation
Scleral Buckle-Related Complications
Retinal Complications
Subretinal Gas (Sulfur Hexafluoride [SF6] and Perfluoropropane [C3F8]) Migration
Silicone Oil Complications
Other Complications
Postoperative Results
Further Reading
III. Other Species
14 Equine Ophthalmic Surgery
Introduction
Orbital Surgery
Surgical Anatomy
Surgical Pathophysiology
Globe Development on Orbit Growth
Strabismus
Orbital Inflammation: Acute and Chronic
Orbital Neoplasms
Perioperative Medications
Types of Orbital Surgeries
Local and Retrobulbar Nerve Blocks in the Horse
Surgical Techniques
Enucleation
Indications
Subconjunctival Enucleation
Transpalpebral Enucleation
Postoperative Management
Implants to Improve Postoperative Appearance after Enucleation
Intraorbital Silicone Prosthesis
Evisceration and Intraocular Silicone Prosthesis
Cosmetic Corneoscleral Conformer, Scleral Cosmetic Shell, and Corneoscleral Prosthesis
Orbital Exenteration in Horses
Postoperative Management after Exenteration
Removal of Prolapsed Retrobulbar Fat
Orbitotomies
Indications for Orbitotomy
Orbital Fractures
Orbital Fracture Repair
Traumatic Proptosis in Horses/Avulsion/Luxation of the Globe
Augmentation of Orbital Volume
Postoperative Care and Management
Surgeries of the Eyelids
Anatomy
Eyelid Sensation
Eyelid Innervation
Eyelid Blood Supply and Lymphatics
Preoperative Considerations
Surgical Considerations of the Eyelids
Surgical Instrumentation
Surgical Preparations of the Eyelids
Tarsorrhaphies
Temporary Tarsorrhaphy in the Horse
Permanent Tarosorrhaphy in the Horse
Aftercare for Tarsorrhaphies
Lateral Canthotomy
Entropion
Surgeries for Entropion
Aftercare with Entropion Surgery
Surgeries for Ectropion
Eyelid Trauma
Surgeries for Eyelid Neoplasia
Blepharoplastic Procedures
Four-Sided Excision
Reconstructive Blepharoplasty
Sliding Skin Graft or H-Plasty
Tarsoconjunctival Advancement Grafts
Sliding Z-Graft
AfterCare for Blepharoplasty
Adjunctive Therapeutic Modalities
Squamous Cell Carcinoma
Cryotherapy
Radiofrequency Hyperthermia
Immunotherapy
Intralesional/Intratumoral Chemotherapy
Radiation Therapy
Carbon Dioxide Laser
Sarcoid
BCG Immunotherapy
Intratumoral (Intralesional) Chemotherapy
Cryotherapy and Radiofrequency Hyperthermia
Brachytherapy
Photodynamic Therapy
Lacrimal and Nasolacrimal Surgeries
Surgical Anatomy
Clinical Diagnostic Tests
Nasolacrimal Catheterization
Surgeries for the Nasolacrimal Apparatus
Lacerations of the Lacrimal Canaliculi
Nasolacrimal Duct Obstructions
Distal Nasolacrimal Duct Atresia in Foals
Surgery for Keratoconjunctivitis Sicca
Parotid Duct Transposition in the Horse
Surgeries of the Conjunctiva and Nictitans
Conjunctival Anatomy
Anatomy of the Nictitans
Bulbar/Palpebral Conjunctival Biopsy (Punch/Snip)
Surgical Repair of Conjunctival Lacerations and Defects
Conjunctival Grafts and Transplantation
Conjunctiva Autografts to Cornea
Advancement (Hood or 180°) Bulbar Conjunctival Grafts
Bridge Bulbar Conjunctival Grafts
Pedicle Bulbar Cinjunctival Grafts
Corneoconjunctival Autograft
Postoperative Patient Management, Success Rates, and Potential Complications
Surgeries of the Nictitans
Nictitating Membrane Flaps
Postoperative Management and Complications
Partial/Complete Excision of the Nictitans
Surgeries of the Cornea and Sclera
Surgical Anatomy
Corneal Diseases
Perioperative Considerations
Surgical Instrumentation for Corneal and Scleral Surgeries
Surgical Procedures for Superficial Corneal Diseases
Superficial Keratectomy (Partial and Complete)
Superficial Punctate and Grid Keratotomies
Diamond Burr Debridement
Surgical Procedures for Deep Corneal Ulcerations
Biomaterial Substitutes
Porcine Small Intestinal Submucosa (SIS) Grafts
Porcine Bladder Submucosa Graft
Amniotic Membrane Grafts
Temporary Tarsorrhaphy
Surgery for Corneal Lacerations
Iris Prolapse
Surgery for Corneal Foreign Bodies
Corneal Adhesives
Surgeries for Corneal Abscesses
Penetrating Keratoplasty
Split-Thickness Penetrating Keratoplasties
Posterior Lamellar Keratoplasty
Deep Lamellar Endothelial Keratoplasty
Deep Anterior Lamellar Keratoplasty (DALK)
Complications
Thermokeratoplasty
Surgeries for Immune-Mediated Keratitis
Surgeries for Limbal and Scleral Diseases
Cryotherapy
Radiation Therapy
Carbon Dioxide Laser
Local Chemotherapy
Surgeries of the Anterior Chamber and Anterior Uvea
Surgical Anatomy
Iris
Ciliary Body
Iridocorneal Angle
Pathophysiology
Perioperative Considerations
Surgeries of the Anterior Chamber
Anterior Chamber Paracentesis
Surgery for Hyphema
Enzymatic Therapy for Hyphema
Anterior Chamber Foreign Bodies and Parasites
Postoperative Management and Complications
Surgeries of the Anterior Uvea
Sectoral Iridectomy/Iridocyclectomy
Photoablation of Enlarged and/or Cystic Corpora Nigra (Granula Iridica)
Cyclosporine Implants for Treatment of Equine Recurrent Uveitis
Suprachoroidal Implantation of the CsA Device
Surgeries for the Glaucomas
Diagnostic and Monitoring Techniques
Medical and/or Surgical Treatment
Surgical Anatomy
Preoperative Treatment
Transscleral Cyclophotocoagulation
Treatment of Blind and Painful Glaucomatous Eyes
Pharmacological Ablation of the Ciliary Body
Surgeries of the Lens and Cataracts
Cataract Classification in Horses
History of Cataract Surgery in Horses
Equine Lens Anatomy
Development of the Intraocular Lens for the Horse
Patient Selection
Maturity of Cataract
Unilateral Cataracts
Bilateral Cataract Surgery
Intraocular Pressure
Preoperative Electroretinography and Ultrasonography
Foals with Cataracts
Preoperative Preparation
Perioperative Medications
Surgeries for Cataracts and Lens Removal
Phacoemulsification in the Horse
Intracapsular Lens or Cataract Extraction
Postoperative Results and Complications
Vitreal Anatomy
Surgical Pathophysiology
Surgery of the Vitreous
Hyalocentesis/Vitreous Paracentesis
Intravitreal Injections
Pars Plana (Anterior) Vitrectomy for Equine Recurrent Uveitis
Patient Selection
Pre- and Postoperative Medication
Surgical Technique
Technical Aspects
Complications
Long-Term Results
Retinal Detachments in Horses
Further Reading
15 Ophthalmic Surgeries in Production Animals
Introduction
Bovine Orbit
Orbital Neoplasms
Perioperative Medications
Types of Orbital Surgical Procedures
Enucleation of the Bovine Eye
Regional Anesthesia and Surgical Preparation
Transpalpebral Enucleation Surgical Technique
Exenteration
Postoperative Management
Eyelid Surgeries
Bovine Eyelid Anatomy
Eyelid Innervation
Eyelid Blood Supply and Lymphatics
Preoperative Examination Procedures
Surgical Instrumentation
Surgical Preparations of the Eyelids
Bovine Eyelid Surgeries
Surgical Repair of Eyelid Lacerations
Temporary Tarsorrhaphy
Four-Sided or House Excision
Sliding Skin Graft or H Plasty
Cryotherapy
Radiofrequency Hyperthermia
Intralesional/Intratumoral Chemotherapy and Immunotherapy
Radiation Therapy
Conjunctiva and Nictitans
Conjunctival and Nictitans Anatomy
Surgeries of the Nictitans
Nictitating Membrane Flaps
Postoperative Management and Complications
Partial/Complete Excision of the Nictitans
Conjunctival Grafts
Surgery of the Cornea and Sclera
Corneal Anatomy
Surgical Pathophysiology
Perioperative Treatment Considerations
Indications for Surgery
Superficial Keratectomy
Cryotherapy
Hyperthermia
Intraocular Surgery in Cattle
Other Species
Entropion in Sheep and Goats
Lens Removal Surgery in Small Ruminants
Surgery for Entropion and Periocular Fat Pads in Potbellied Pigs
Further Reading
16 Ophthalmic Surgeries in Exotic and Zoo Species
Introduction
Orbit and Globe
Rabbit
Enucleation and Orbitotomy in Rabbits
Avian
Enucleation in Birds
Transaural Enucleation Method for Owls
Globe-Collapsing Enucleation Procedure for Birds
Modified Evisceration for Enucleation in Birds
Eyelid Surgeries
Sea Turtles (Chelonia Tortuga):Surgeries to Excise Eyelid and Corneoconjunctival Tumors
Eyelid Surgery in Big Cats with Lid Agenesis
Nasolacrimal Disease
Reptilia: Snakes
Distal Nasolacrimal Duct Atresia in Llamas (Lama Glama) and Alpacas (Vicugna Pacos)
Conjunctiva and Nictitans
Conjunctival Grafts
Surgery for Aberrant Conjunctival Overgrowth in Rabbits
Glaucomas
Lens and Cataract Surgeries
Snakes
Loggerhead Turtles
Pet Birds and Penguins
Raptors
Rabbits
Kangaroos
Pinnipeds
Tigers (Panthera Tigris) and Other Large Cats
Llamas
NonHuman Primates
Further Reading
Index