A modified ab externo approach for suture fixation of an intraocular lens implant in the dog

The goals of canine cataract and lens instability surgery should be to ensure a small incision, minimal tissue trauma, shortened surgical time, maintenance of the anterior chamber, and restoration of emmetropia through the use of a stable intraocular lens specifically designed for the canine eye. While this is usually the case with routine phacoemulsification and in-the-bag intraocular lens implantation, it is often not the case with lens instability, lens luxation or large posterior capsular ruptures. In such cases the incisions are often larger, surgical time and tissue trauma are excessive, and the patient is often left aphakic. The goal of this paper is to present a modified ab externo technique designed to allow removal of the lens and placement of a ciliary sulcus sutured IOL through a small incision, with minimal trauma and shortened surgical time. Use of this technique may allow more canine patients to be emmetropic postoperatively. In addition, the ease of this procedure may encourage earlier removal of an unstable lens and decrease the risk of secondary glaucoma and retinal detachment that occur in association with lens luxation.