Die chirurgische Behandlung von Augenkrankheiten beim Pferd

Surgical techniques in equine ophthalmology – A literature review -
The objective of the presented study is to provide a comprehensive
review of surgical intervention techniques and their results in the
treatment of equine ophthalmologic disorders. The study surveys
English, German and, to a limited degree, French literature
beginning in the middle of the 19th century till today, including
books, journal articles, conference proceedings and theses in the
field of veterinary surgery, ophthalmology and equine diseases.
Data was collected by screening of titles, keywords and
bibliography of available literature and by using computer
databases such as Vet-CD and Medline. Copies of the cited
literature were obtained from the libraries of the Veterinary
faculties in Munich, Hanover and London, the central library of the
Ludwigs-Maximilians-University in Munich and the Bavarian library
in Munich (Bayerische Staatsbibliothek). The chapter plan follows
the anatomy of the eye and each chapter is subdivided into
treatments of specific disorders. In addition chapter 1. eyelids,
3.1. conjunctiva, 3.2. third eyelid and 4. cornea include sections
about specific operations performed on these structures. The horse
was in the centre of surgical and ophthalmologic veterinary
research and clinical work at the end of the 19th and the beginning
of the 20th century - as it is reflected by the number of
publications in these fields. Over the following years interest in
equine ophthalmology lessened and it took till the last quarter of
the 20th century to become an issue of interest again. In the
meanwhile veterinary ophthalmology concentrated on small animals,
especially the dog. Aetiopathogenesis and treatment of
ophthalmologic disorders in the horse were hardly investigated and
the specific anatomy and physiology of the equine eye were not
considered to be of clinical interest. At the beginning of the 20th
century reports about surgical treatment of equine ophthalmologic
disorders are characterised by high case numbers, but lack
statistical analysis of the data and many have in fact almost
“anecdotal” form. Recent research follows today´s scientific
standard methods and comprises case reports, retrospective and, to
a lesser degree, prospective studies. Case numbers in this field of
research are still low and comparison of different treatment
methods is difficult due to the variety of disorders presented and
the difference in study design. Some publications are missing out
on important parameters, such as the quality of eye sight achieved
after surgery; others use subjective judgement, but do not perform
objective evaluation of certain parameters. There is also an
obvious discrepancy between clinical prevalence of a disorder and
the number of case reports dealing with it, e.g. corneal
laceration, glaucoma. Some surgical techniques developed for small
animals can be applied to the equine eye. However, this is not
possible for all methods and the techniques may require at least
species specific modifications. There are controversial discussions
among the specialists in the field of equine ophthalmology with
regards to indication of surgery and surgical technique, even down
to the question which suture material is best. Today´s surgical
techniques in equine ophthalmology seem to be far away from
standardisation. More prospective and well-designed studies are
desirable to provide comparable data for the different techniques
in the future.