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Pain management and intraocular pressure monitoring following phacoemulsification

02 December 2021
8 mins read
Volume 12 · Issue 10
Figure 1. Cataract in a dog.


Phacoemulsification is the gold standard procedure for cataract removal in veterinary patients. Registered veterinary nurses involved in the care of patients undergoing this surgery should be aware of potential complications postoperatively and tailor their nursing considerations to individual patients. Pain assessment in ophthalmic patients should take a different format to that in traditional soft tissue or orthopaedic surgeries, and monitoring of intraocular pressure is an important part of postoperative care. This report aims to discuss these nursing interventions for a patient nursed in a referral hospital setting.

Acataract is a white opacity of the lens which obscures vision by blocking light from reaching the cornea (Moore, 2011) (Figure 1). Cataracts are often hereditary but can also be congenital, developmental, or secondary to metabolic disease (Moore, 2011). Diabetes mellitus is a common cause of cataracts in dogs (Hyde, 2011). An increased glucose concentration in the lens, converts to sorbitol, which acts as an osmotic agent to draw water into the lens, resulting in loss of transparency and cataract formation (Woodham-Davies, 2019). Bilateral cataracts will develop in 50–70% of dogs in the first year following diagnosis of diabetes mellitus regardless of how well the disease is managed (Woodham-Davies, 2019). Cataracts cannot be medically managed, therefore surgical removal of the cataract is indicated (Woodham-Davies, 2019). A number of surgical techniques exist such as extracapsular lens extraction, intracapsular lens extraction and phacoemulsification (Ramani et al, 2013). Case presentation is a deciding factor on which surgical technique is to be used, for example a cataract causing secondary lens luxation to the anterior chamber would likely require an intracapsular lens extraction. Phacoemulsification is the most commonly used method and generally is considered gold standard by veterinary ophthalmologists (Ramani et al, 2013).

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