Harathi Krishnan1, Scott Hetzel2, Gillian J McLellan1,3, Ellison Bentley1. 1. Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA. 2. Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI, USA. 3. Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, USA.
Abstract
OBJECTIVE: To compare outcomes of surgical intervention and nonsurgical management of canine cataracts. METHODS: Records of patients examined for cataracts from January 2007 to February 2018 were divided into two groups: nonsurgical and surgical. The nonsurgical group was further subdivided based on whether the decision not to pursue surgery was elected by owners, or based on ophthalmologist's advice. Inclusion criteria included 6 months of follow-up. Success in the nonsurgical group was defined as a comfortable eye with no potentially painful complications, and success in the surgical group additionally required vision. Time-to-failure (complications) was assessed with Cox proportional hazards models. RESULTS: A total of 72 eyes (41 dogs) were included in the nonsurgical group, and 126 eyes (67 dogs) were surgically treated. There was no difference in gender or age; however, the surgical group had significantly more diabetic eyes (56.3% vs 15.3%; P < .001) and patient eyes with longer follow-up times (median 37.6 months vs 22.1 months; P < .001) than the nonsurgical group. There was no statistically significant difference in complication rates between the nonsurgical group (15/72 [20.8%]) and the surgical group (23/126 [18.3%]; HR: 2.22 [0.97, 5.0]; P = .060). However, the complication rate in the ophthalmologist-led nonsurgical group was significantly greater than in the owner-led nonsurgical group (P = .019) and the surgical group (P = .002). CONCLUSIONS: When using relevant outcomes, whether or not a cataractous eye has surgery does not affect long-term complications; additionally, nonsurgical eyes that are poor surgical candidates have a higher complication rate than eyes deemed suitable for phacoemulsification for which owners elected not to pursue cataract surgery.
OBJECTIVE: To compare outcomes of surgical intervention and nonsurgical management of caninecataracts. METHODS: Records of patients examined for cataracts from January 2007 to February 2018 were divided into two groups: nonsurgical and surgical. The nonsurgical group was further subdivided based on whether the decision not to pursue surgery was elected by owners, or based on ophthalmologist's advice. Inclusion criteria included 6 months of follow-up. Success in the nonsurgical group was defined as a comfortable eye with no potentially painful complications, and success in the surgical group additionally required vision. Time-to-failure (complications) was assessed with Cox proportional hazards models. RESULTS: A total of 72 eyes (41 dogs) were included in the nonsurgical group, and 126 eyes (67 dogs) were surgically treated. There was no difference in gender or age; however, the surgical group had significantly more diabetic eyes (56.3% vs 15.3%; P < .001) and patient eyes with longer follow-up times (median 37.6 months vs 22.1 months; P < .001) than the nonsurgical group. There was no statistically significant difference in complication rates between the nonsurgical group (15/72 [20.8%]) and the surgical group (23/126 [18.3%]; HR: 2.22 [0.97, 5.0]; P = .060). However, the complication rate in the ophthalmologist-led nonsurgical group was significantly greater than in the owner-led nonsurgical group (P = .019) and the surgical group (P = .002). CONCLUSIONS: When using relevant outcomes, whether or not a cataractous eye has surgery does not affect long-term complications; additionally, nonsurgical eyes that are poor surgical candidates have a higher complication rate than eyes deemed suitable for phacoemulsification for which owners elected not to pursue cataract surgery.
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