New Techniques in Veterinary Ophthalmology Offer Successful Outcomes

Miniature probes that utilize micro-incisions and require only a stitch or two for recovery - lasting results – healthy animals and happy clients. Those are some of the results of a recent investment in endoscopic laser equipment now in regular use in the Veterinary Teaching Hospital for glaucoma surgery and in combination with cataract surgery.

Lasers have been used in eye surgery for years, particularly with glaucoma. "Lasers come in a variety of wavelengths and vary in their delivery systems," explained Dr. David Wilkie, professor in the Department of Veterinary Clinical Sciences. "Lasers differ in the wavelength of light and the tissue they interact with. In the type of laser most commonly used in veterinary ophthalmology, the 810nm wavelength interacts with melanin, or pigmented tissues."

The next issue is delivering the laser energy to the appropriate target. "Prior to the use of the endolaser, the target tissue was not visualized during glaucoma procedures," said Dr. Wilkie. "We knew where to put the probe, because we understand the anatomy of the eye, but we couldn't actually see the target or the effect."

"With the endolaser, the theory is that it's better to actually see what you are doing," he said. "We can now go inside the eye with a 20-gauge instrument that offers light, video and laser. We can drive the probe right to the target, see it on the monitor, treat it, and see the effect."

The ophthalmology department is routinely performing cataract and glaucoma surgery every week, often on patients whose owners have driven long distances for treatment. Recently, a client drove to Columbus from Virginia. The dog previously had cataract surgery elsewhere and then developed increasing intraocular pressure, a sign of glaucoma. Because the dog had just one eye, the family wanted to make sure he received the best possible treatment. "They drove 10 hours to get here," said Dr. Wilkie. "Our goal for our patients is for a return to normal life following surgery," he said. "They will chase balls, chase Frisbees and return to the active life they had prior to their eye problems. We used to talk about keeping dogs with glaucoma sighted for weeks to months, now we can often keep them sighted for years."

He attributes the improved results to a combination of better drugs, improved instruments, and better diagnostic capabilities in the hands of primary care givers, the general veterinarian.

"I don't see the chronic end-stage diseases that I saw 20 years ago," he said. "Family veterinarians are very familiar with eye problems and are often quick to make a diagnosis. We used to get glaucoma referrals after the dog was already blind, and there was nothing we could do except to make the dog comfortable. Now, referring veterinarians catch problems much earlier, the overall level of awareness is up and that makes us all more successful in maintaining vision."

Other improvements are in the treatment of cataracts and include the ability to replace a cataractous lens with a foldable synthetic lens. These synthetic lenses are made from a soft acrylic polymer and are foldable allowing them to be implanted through a small incision. Removing the cataract and replacing the lens can be as quick as a 15-minute procedure using a tiny incision that requires only a few stitches. With the endolaser, a combined procedure can be performed on dogs with cataracts and early glaucoma during the same surgery, thus, restoring vision and decreasing long-term complications.

"Ohio State is one of several regional centers for cataracts and endolaser," said Dr. Wilkie. "We're keeping our clients happy and our patients sighted. We all benefit from being busy. Building awareness of our capabilities benefits everyone and improves the standard of care."

For more information on ophthalmic endolaser surgery, please call 614-292-3551 and ask to speak with one of our ophthalmologists.

Written by: Melissa Weber