Безопасность и эффективность парацентеза передней камеры с одномоментным внутрикамерным введением 0,5%-го пилокарпина при глаукоме различной этиологии у собак и кошек

Abstract

Purpose. In animals with glaucoma to determine the technique for conducting ACP with simultaneous administration of a 0.5 % pilocarpine solution, to identify the dynamics of IOP reduction, as well as effectiveness of this procedure both after and in the long term. Based on analysis of data obtained, highlight the complications of this procedure.
 
 Materials and methods. Study included 37 animals (39 eyes): 24 dogs and 13 cats with glaucoma, which, according to anamnesis, developed no more than 10 days without any preliminary ocular hypotensive therapy. All animals underwent ACP without general anesthesia or sedation. Immediately before procedure, animals were instilled with a local anesthetic in conjunctival sac (0.5% proxymethacaine). ACP was performed under 6-fold magnification using a 27G headlamp with 9 hours for right eye and 3 hours for left eye. A puncture was carried out at periphery of cornea 1 mm from limbus. Volume of aspirated AH was no more than 2 drops. After that, needle was removed from the AC. Next step was intracameral injection of 0.5% solution of pilocarpine through hole of paracentesis. Volume of injected solution did not exceed 0.3 ml. After paracentesis and administration of pilocarpine solution, subconjunctival administration of dexamethasone solution in combination with gentamicin and novocaine was performed. Immediately after ACP, antihypertensive therapy was prescribed from a combination of eye drops: synthetic analogues of prostaglandins F2α (travoprost 0.004%) in combination with non-selective beta-blockers (timolol maleate 0.5%), as well as carbonic anhydrase inhibitors (brinzolamide 1%) every 12 hours.
 
 Results. Average IOP was in animals before ACP 60.26 ± 16.32 mmHg; immediately after procedure ― 10.15 ± 3.23 mm Hg; 1 hour after ACP ― 13.28 ± 3.09 mm Hg; after 7 days ― 17.61 ± 6.03. Immediately after intracameral administration of a 0.5% pilocarpine solution, we observed a rapid and pronounced narrowing of the pupil within 1…2 minutes. Myosis was noted for at least 1 hour after procedure. There were no adverse reactions from administration of pilocarpine solution in AC. Among complications after immediately 1 hour after the ACP, we encountered aqueous flare in 12 eyes (31% of cases) and moderate hyphema in 5 eyes (13% of cases). 7 days after procedure, no complications were observed.
 
 Conclusion. This study shows that ACP with simultaneous intracameral administration of 0.5% pilocarpine solution is effective in dogs and cats without any significant side effects. These results allow us to offer ACP as a procedure for an emergency reduction in IOP, especially in acute attacks of glaucoma in dogs and cats.