Treatment rationales and outcomes for cats with lens luxation: 136 eyes (2007-2023)

ObjectivesThe aim of the present study was to evaluate outcomes in cats with lens luxation treated with intracapsular lens extraction (ICLE), medical management or transcorneal lens reduction (TCLR), and to investigate the reasoning behind treatment recommendations.MethodsMedical records were retrospectively reviewed to identify cats with lens luxation. Data collected included signalment, examination findings, treatment decision and rationale for treatment, and outcome.ResultsRecords were reviewed for 136 eyes from 115 cats. Male cats (77%) were overrepresented. Of the eyes, 83/136 (61%) were non-visual on presentation. Medical management was initially elected for 79/136 (58%) eyes, enucleation for 32/136 (24%), ICLE for 12/136 (9%) and TCLR for 7/136 (5%), while no treatment was elected for 3/136 (2%) eyes. Two cats were euthanized (2/136 eyes, 1%) and one eye underwent diode laser cyst ablation. TCLR was not successful in any eyes. Of eyes with follow-up, 12/13 (92%) eyes that underwent ICLE as primary or secondary management were visual and normotensive (intraocular pressure [IOP] <25 mmHg), while 19/50 (38%) medically managed eyes were visual and normotensive. However, 33/50 (66%) medically managed eyes were normotensive at last recheck and 17/23 (74%) medically managed eyes that were visual on presentation remained visual at last recheck. Treatment rationale was noted for 94 eyes. Factors cited included visual status (40%), perceived comfort (36%), age or medical history (29%), financial limitations (12%), inability to medicate (10%), other ocular examination findings (9%) and potential risk of feline post-traumatic ocular sarcoma after ICLE (7%).Conclusions and relevanceTCLR does not appear to be a viable treatment modality in cats. Medical management of lens luxation may produce acceptable results for IOP control and retention of vision when ICLE is not possible. Providing cat owners with accurate information about outcomes and financial implications of treatment options for lens luxation is critical.