Cataract surgery is approximately 85% successful. However, this means that in 15% of cases, complications may prevent vision recovery or result in later vision loss. The purpose of the examinations before and after cataract surgery is to detect, prevent, or treat these complications early whenever possible. In uncomplicated cases, vision will begin to noticeably improve within a few days; after six weeks, healing is usually complete and vision is at its best.
There is no effective medical treatment for cataracts.
The human and veterinary ophthalmology communities are united in their conclusion that cataract is a surgical disease. Veterinarians are smart people, but we are also extremely empathetic and sensitive to the economic concerns of our clients. An understandable unwillingness to pressure clients into expensive surgery may leave us vulnerable to the false promises of unregulated “nutraceuticals.” Antioxidant “cataract dissolving” eye drops are one example of this. The thought of simple eye drops that can help to avoid expensive surgery is so very attractive. Unfortunately, this is one of those situations that is definitely too good to be true.
Not only is there no scientific evidence that medical therapy for the prevention or dissolution of cataracts using antioxidants is effective, the few published studies that have been done present evidence that antioxidant cataract dissolution drops like Ocluvet don’t work. For a summary, see this skeptvet article.
Although these eye drops are obviously less expensive than surgery, they are still moderately expensive ($50-100/bottle), need to be continued indefinitely, and are a complete waste of your client’s money. Their use may actually have a detrimental effect by encouraging client’s to leave their pet’s cataracts unmonitored until such time as complications such as lens induced uveitis, lens luxation, and secondary glaucoma develop, preventing successful surgery.
The best recommendation to a client whose pet has cataracts is early evaluation by a veterinary ophthalmologist so that a surgical plan can be made that optimized recovery of vision and quality of life.
UPDATE: A pharmaceutical eye drop may soon become available to reduce the risk of the hyperglycemic cataract development in dogs.
Once the doctor has examined your pet and cataract surgery has been agreed upon, a blood analysis will be done to detect any generalized illness and assess any inherent risks associated with general anesthesia.
Eye drops will be dispensed to be started before the cataract surgery. You will use these medications after the cataract surgery as well.
Your pet will be admitted to the hospital on the morning of the cataract surgery.
The hair will be clipped from the area around the eyes and one the front legs (to administer the anesthetic).
Prior to the operation, an electroretinogram test will be performed to confirm adequate function of the retina.
The cataract surgery takes approximately one hour per eye. Your pet will be monitored in the hospital for a few hours after cataract surgery.
Although overnight hospitalization is not required, they will need to come back for the first re-examination the day after cataract surgery.
When your pet goes home, they will be wearing a firm plastic collar to prevent them from rubbing at the eyes. Although they may not like it, they will learn to tolerate the collar and can eat and sleep with it on.
It is essential to avoid injury to the eyes after this delicate surgery. Please keep your pet quiet and avoid direct nose to nose contact with other animals during the first two weeks post-surgery.
No bathing or uncontrolled exercise.
Leash-walking is acceptable.
Following cataract surgery (in people as well as dogs) there is no substantial discomfort; thus pain medication is not necessary. Dogs have a greater degree of post-operative inflammation, however, so anti-inflammatory medications are used extensively and for a longer period after surgery than is needed for our human counterparts.
Additional re-examinations will be scheduled at 1, 2, 4, and 6 weeks after the cataract surgery to monitor progress and then as needed.