Intrascleral ocular prosthesis following evisceration in thirteen horses

Abstract

A multitude of ocular diseases can lead to a loss of vision and permanent ocular pain in horses. The present paper addresses the topic of cosmetic and reconstructive surgery in equine ophthalmological patients based on the implantation of intrascleral silicone prostheses. Thirteen horses aged between four and twenty years with various ocular problems requiring removal of a blind and/or painful eye were placed under general anaesthesia. After evisceration of the globe, a silicone prosthesis was introduced into the sclera. Sclera and conjunctiva were sutured and the horses were treated with NSAIDs and ophthalmic ointments postoperatively. After healing of the surgical wound, a dark tinted bandage lens could be placed over the eye by the owner to further enhance the cosmetic result. The surgical wounds healed well in all horses. One horse had a deep corneal ulceration and the prosthesis had to be removed two weeks after surgery. Two horses developed eosinophilic keratitis six and eight weeks after surgery, respectively. The condition was repeatedly treated with a diode laser and ophthalmic ointments and resolved subsequently. One horse showed transient swelling in the surroundings of the eye that resolved within two days. The corneas of the eyes that underwent surgery passed through various stages of cloudiness and vascularization, as well as epithelial reconstruction, followed by pigmentation. Intrascleral silicone prostheses in combination with a dark tinted bandage lens yield a cosmetically excellent result that is well received by the owners. It serves as a cosmetically superior alternative to plain enucleation or enucleation and subsequent placement of an intraorbital prosthesis in cases where the removal of a blind and/or painful eye is inevitable.