Technology and Microsurgery

The technology now available for use in veterinary cataract surgery has opened up new horizons in this field. By adapting techniques from best practice in human surgery, useful vision can be regained in about 95% of patients. Most dogs are able to see well enough to catch a ball. The most often repeated phrase used by owners is that their pet is "back to his or her old self". This improvement in quality of life is the primary objective of cataract surgery.

In common with other branches of veterinary work, the techniques and lessons learned in one species can be adapted and applied to others. A little owl, a white breasted sea eagle, various hawks, a pet cockatiel called Jimmy, Ceriol the hedgehog, Sammy the orphaned Bennets Wallaby and Sam Dix, a 10-year-old donkey, have all had sight restored using these techniques at Eye Veterinary Clinic.

Recent reports have also highlighted the Bengali tiger treated in Coventry, a crow at the Animal Health Trust, Newmarket, and a Tawny Owl in Southampton. This work is now being offered in a handful of veterinary ophthalmology referral centres and depends for success on the provision of quality modern equipment, on micro-surgical expertise and on attention to detail.

Equipment for this work is expensive. An essential for success is to have a perfectionist's approach. The intraocular tissues are delicate. When a single mistake can result in total loss of vision, it is important to have the optimum operating conditions.

Microsurgery, by definition, is surgery carried out looking down a microscope. This may be obvious but it is essential for accurate fine work. The principles of conventional surgery are applied, only on a smaller scale, with instruments scaled down accordingly. Unfortunately, the price of surgical instruments seems to be inversely proportionate to size!

A good quality operating microscope is the central purchase. This will have a light source described as coaxial to the optical axis of the microscope, providing the light beam is within five degrees of the central microscope axis. This means that the fundus is illuminated during cataract surgery, giving a back-lighting effect.

It is much easier to make a total clearance of the often softer peripheral lens material. The magnification allows the use of sutures normally 10/0, just thinner than a human hair, for corneal closure.