Corneal sensitivity and aqueous tear production in dogs undergoing evisceration with intraocular prosthesis placement

Objective To determine whether there is an association between evisceration with intraocular prosthesis placement via a dorsal scleral approach and decreased corneal sensitivity or aqueous tear production in dogs. Design Prospective study. Procedure Twenty-one dogs scheduled to undergo unilateral evisceration with intraocular prosthesis, and with a normal normotensive contralateral eye, based on slit-lamp biomicroscopy, indirect ophthalmoscopy and applanation tonometry, were included in the study. Central corneal sensitivity was measured with a Cochet-Bonnet esthesiometer prior to (week 0) and 2, 7, 14 and 28 weeks following surgery. Other pre- and postoperative data collected were Schirmer's tear test (STT I), Schirmer's tear test with topical anesthesia (STT II), corneal fluorescein retention, and intraocular pressure (IOP; postoperative control eye only). Axial globe length was determined for both eyes. Scleral incision length in the surgery eye was also recorded. Results Corneal sensitivity was significantly lower in eyes undergoing evisceration with intraocular prosthesis than in control eyes both preoperatively and postoperatively at all time points. There was no significant difference between preoperative and postoperative corneal sensitivity within the two groups. There was no significant difference in STT I or STT II-values between control eyes and surgery eyes preoperatively. There was a significant difference between preoperative and 2-week postoperative STT I in the surgery eye. There was a significant difference between the preoperative and 28-week postoperative STT II in the surgery eye. The 28-week postoperative STT I-values differed significantly between control and surgery eyes. Corneal sensitivity tended to decrease with increased degree of buphthalmos or with increased scleral incision length, although neither relationship was statistically significant. Conclusions Eyes that have sustained chronically elevated intraocular pressure had decreased axial corneal sensitivity compared to normal eyes, which persisted even after intraocular pressure was reduced. The presence of buphthalmos appeared to be a factor in globes developing decreased corneal sensitivity. Evisceration via a dorsal scleral incision did not result in a significant further reduction in axial corneal sensitivity. A mild reduction in aqueous tear production occurred over time in globes following evisceration with intraocular prosthesis.