Retrospective study of the prevalence of keratoconjunctivitis sicca in diabetic and nondiabetic dogs after phacoemulsification.

OBJECTIVE To evaluate the prevalence of keratoconjunctivitis sicca (KCS) in diabetic and nondiabetic dogs following phacoemulsification. PROCEDURES Medical records were reviewed for signalment, body weight, diabetes status, and STT at the preoperative and all postoperative examinations. A clinical diagnosis of KCS was defined as a STT <15 mm/min with compatible clinical signs. Schirmer tear test values and the prevalence of KCS based on STT <15 mm/min were evaluated at 2-4, 5-8, 9-14, 15-20, and 41-52 weeks postoperatively. Size of dog (large, >10 kg; small, ≤10 kg) and STT ranges (<15 mm/min, 15-22 mm/min and >22 mm/min) were categorized for analysis of effect of body weight and STT on prevalence of KCS. RESULTS One hundred and seventeen nondiabetic (198 eyes) and 118 diabetic dogs (228 eyes) were evaluated. KCS was diagnosed in nearly twice as many diabetics as nondiabetics (27.4% vs. 15.4%) within 2 weeks postoperatively (P = 0.0088). Percentage of eyes with KCS among all dogs decreased over time and did not differ significantly after the first postoperative visit. Diabetic small dogs were 1.7 times more likely to have KCS than nondiabetic small dogs (P = 0.0052). Preoperative STT was significantly associated with likelihood of postoperative KCS among large (P < 0.0001), but not small dogs (P = 0.0781). Among large dogs, eyes with STTs between 15 and 22 mm/min were approximately 3 times more likely to be diagnosed with KCS after surgery than those with STT >22 mm/min. CONCLUSION The greatest risk for KCS for all dogs is during the first 2 weeks postoperatively. Populations at greatest risk for postoperative KCS are small dogs, small diabetic dogs, and large dogs with preoperative STT ≤22.

[1]  Michael R Shaughnessy,et al.  Effect of duration and type of anesthetic on tear production in dogs. , 2011, American journal of veterinary research.

[2]  C. Waldner,et al.  Cataracts in 44 dogs (77 eyes): A comparison of outcomes for no treatment, topical medical management, or phacoemulsification with intraocular lens implantation. , 2011, The Canadian veterinary journal = La revue veterinaire canadienne.

[3]  C. Colitz,et al.  Tear production in normal juvenile dogs. , 2010, Veterinary ophthalmology.

[4]  D. Gould,et al.  A comparison of anesthetic complications between diabetic and nondiabetic dogs undergoing phacoemulsification cataract surgery: a retrospective study. , 2010, Veterinary ophthalmology.

[5]  A. Álvarez-Barrientos,et al.  The effect of preservative-free HP-Guar on dry eye after phacoemulsification: a flow cytometric study , 2010, Eye.

[6]  Charles L. Martin Ophthalmic Disease in Veterinary Medicine , 2009 .

[7]  Ye-sheng Xu,et al.  Changes of tear film and tear secretion after phacoemulsification in diabetic patients , 2008, Journal of Zhejiang University SCIENCE B.

[8]  A. Tomlinson,et al.  Changes in corneal sensitivity and tear physiology after phacoemulsification , 2008, Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians.

[9]  T. Fall,et al.  Diabetes mellitus in a population of 180,000 insured dogs: incidence, survival, and breed distribution. , 2007, Journal of veterinary internal medicine.

[10]  W. Wang,et al.  Investigation of Dry Eye Disease and Analysis of the Pathogenic Factors in Patients after Cataract Surgery , 2007, Cornea.

[11]  D. Schaeffer,et al.  Corneal sensitivity and aqueous tear production in dogs undergoing evisceration with intraocular prosthesis placement. , 2007, Veterinary ophthalmology.

[12]  R. English,et al.  Effect of topical 0.02% tacrolimus aqueous suspension on tear production in dogs with keratoconjunctivitis sicca. , 2005, Veterinary ophthalmology.

[13]  A. Webb,et al.  Keratoconjunctival effects of diabetes mellitus in dogs. , 2005, Veterinary ophthalmology.

[14]  M. Herrtage,et al.  Study of 253 dogs in the United Kingdom with diabetes mellitus , 2005, Veterinary Record.

[15]  S. Vinker,et al.  Dry eye in diabetic patients. , 2005, American journal of ophthalmology.

[16]  S. E. Andrew,et al.  Effect of topical tropicamide on tear production as measured by Schirmer's tear test in normal dogs and cats. , 2003, Veterinary ophthalmology.

[17]  Xiaonan Xue,et al.  Estimating the relative risk in cohort studies and clinical trials of common outcomes. , 2003, American journal of epidemiology.

[18]  P. Fang,et al.  Geotechnical behavior of the MSW in Tianziling landfill , 2003, Journal of Zhejiang University. Science.

[19]  G. Ozdemir,et al.  Risk factors for ocular surface disorders in patients with diabetes mellitus. , 2003, Diabetes research and clinical practice.

[20]  T. Chikama,et al.  Correlation of Corneal Sensation, but not of Basal or Reflex Tear Secretion, With the Stage of Diabetic Retinopathy , 2003, Cornea.

[21]  M. Doğru,et al.  Tear function and ocular surface changes in noninsulin-dependent diabetes mellitus. , 2001, Ophthalmology.

[22]  I. Herring,et al.  Evaluation of aqueous tear production in dogs following general anesthesia. , 2000, Journal of the American Animal Hospital Association.

[23]  R. Nelson,et al.  Reliability of history and physical examination findings for assessing control of glycemia in dogs with diabetes mellitus: 53 cases (1995-1998). , 2000, Journal of the American Veterinary Medical Association.

[24]  M. Goebbels Tear secretion and tear film function in insulin dependent diabetics , 2000, The British journal of ophthalmology.

[25]  S. Beam,et al.  A retrospective-cohort study on the development of cataracts in dogs with diabetes mellitus: 200 cases. , 1999, Veterinary ophthalmology.

[26]  M. Kohlhaas Corneal sensation after cataract and refractive surgery , 1998, Journal of cataract and refractive surgery.

[27]  K. Branson,et al.  Effects of intramuscular sedative and opioid combinations on tear production in dogs. , 1998, Veterinary ophthalmology.

[28]  M. Zimmerman,et al.  Tear Film Changes Associated with Normal Aging , 1996, Cornea.

[29]  K. Muñana Long-term complications of diabetes mellitus, Part I: Retinopathy, nephropathy, neuropathy. , 1995, The Veterinary clinics of North America. Small animal practice.

[30]  S. Roberts,et al.  Ocular manifestations of diabetes mellitus: diabetic cataracts in dogs. , 1995, The Veterinary clinics of North America. Small animal practice.

[31]  M. C. Mañé,et al.  Keratoconjunctivitis sicca and diabetes mellitus in a dog. , 1992, Journal of the American Veterinary Medical Association.

[32]  R. Kaswan,et al.  A new perspective on canine keratoconjunctivitis sicca. Treatment with ophthalmic cyclosporine. , 1990, The Veterinary clinics of North America. Small animal practice.

[33]  D. Sullivan,et al.  Age‐ and gender‐related influence on the lacrimal gland and tears , 1990, Acta ophthalmologica.

[34]  A. Brightman,et al.  Decreased tear production associated with general anesthesia in the horse. , 1983, Journal of the American Veterinary Medical Association.

[35]  L. Glickman,et al.  Epizootiologic patterns of diabetes mellitus in dogs. , 1982, American journal of veterinary research.

[36]  L. Lowenstine,et al.  Diabetes mellitus in dogs: a review of initial evaluation, immediate and long-term management, and outcome. , 1977, Journal of the American Veterinary Medical Association.

[37]  R. Peiffer,et al.  Evaluation of tear formation in the dog, using a modification of the Schirmer tear test. , 1975, Journal of the American Veterinary Medical Association.

[38]  D. Mellor,et al.  Effects of medetomidine and medetomidine-butorphanol combination on Schirmer tear test 1 readings in dogs. , 2006, Veterinary ophthalmology.

[39]  V. Adams,et al.  Effect of age, gender, weight, and time of day on tear production in normal dogs. , 2006, Veterinary ophthalmology.

[40]  K. L. Good,et al.  Corneal sensitivity in dogs with diabetes mellitus. , 2003, American journal of veterinary research.

[41]  Berger Sl,et al.  The fluctuation of tear production in the dog , 1998 .

[42]  R. Brand,et al.  Corneal function during normal and high serum glucose levels in diabetes. , 1998, Investigative ophthalmology & visual science.

[43]  T. Krupin,et al.  Decreased basal tear production associated with general anesthesia. , 1977, Archives of ophthalmology.