Intracapsular Lens Extraction in Dogs

The lens of the eye is located behind the iris and is a transparent structure which focuses optical images on the retina. It is located in the patellar fossa and is held in place by small fibrous ligaments called zonules. The lens can develop cataracts or become displaced either as a result of glaucoma, degeneration of the zonules, or due to other causes. A displaced lens can also cause glaucoma, resulting in a buildup of intraocular pressure which will cause damage to the eye that is irreversible if left untreated. Lens luxation, or displacement, occurs when the lens tears free of its zonular fibrous attachments. In many instances, the underlying causes of lens luxation, glaucoma, and cataracts can be treated medically, but sometimes surgical intervention is required. Surgical removal of a luxated lens including the membrane-like capsule of the lens is called intracapsular lens extraction. This surgery is more invasive than the alternative extracapsular lens extraction, which leaves the lens capsule in place and allows for an artificial lens to be inserted in the dog’s existing lens capsule, which provides better attachment and alignment, and therefore intracapsular lens extraction is not performed as often. When profound damage has occurred and vision can not be restored or when damage to the lens capsule has also occurred, intracapsular lens extraction may be a viable option. This procedure is performed by a veterinary ophthalmic surgeon under general anesthetic.

Prior to surgery, you will be required to fast your dog from food for 12 hours. Upon presentation for surgery with an ophthalmic veterinarian, your dog will be sedated, administered intravenous anesthetic and a tube inserted to maintain anesthetic by gas. A large incision will be made into the eye as the lens and capsule need to be removed. An incision is made at 120 to 180 degrees to the lens to reveal the lens and lens capsule. The lens and capsule will be detached along with any remaining zonular attachments and carefully removed. Your dog will be put in recovery from anesthesia and monitored carefully while they regain consciousness so as not to injure themselves or their optical area where surgery has just been performed.

Intracapsular lens extraction eliminates the pain and discomfort associated with lens luxation or subluxation and relieves intraocular pressure from acute glaucoma that may result. If the procedure is performed while the dog still has some vision, some vision will remain, although without the lens and capsule present it will be quite impaired. An alternative procedure, extracapsular lens extraction, is more commonly performed that allows the lens capsule to remain in place and an artificial lens to be inserted in the existing capsule to allow for fixation and alignment. 

After surgery, medications to address eye disease as well as medications to address symptoms such as pain and inflammation will be prescribed by your veterinarian and should be administered as directed. Medications for eye diseases to address intraocular pressure issues present may be continued for several weeks to months after surgery. You will need to ensure that your dog does not interfere with their eye area and an e-collar will be required to keep the surgical area safe from scratching. Post-surgery, vision will be severely impaired and you may need to assist your dog with negotiating their environment. You will require multiple postoperative follow-up visits with your veterinarian to monitor eye condition and recovery. Your veterinarian will advise you on a follow-up schedule.

Intracapsular lens extraction in your dog requires specialized ophthalmic training by your veterinary surgeon and costs reflect this. The cost of lens extraction in your dog can range from $500 to $3,000 per eye. This includes evaluation, anesthetic, procedure, postoperative care, and medications.

Many complications are possible with lens extraction surgery including hemorrhage, inflammation of the eye, ulceration of the cornea, glaucoma, retinal detachment, and blindness. It may be possible to manage complications with medications and should they occur, contact your veterinarian as soon as possible to address.

For dogs for whom hereditary lens luxation is a factor, removal from a breeding program is required. As this disease may not manifest until after an individual dog has been used for breeding purposes, genetic testing to indicate whether risk factors for hereditary lens luxation are present can be performed on younger dogs to determine suitability for breeding. If one eye has experienced lens luxation, the other eye can be examined prior to luxation for indications of weakening of the zonules and preventative lens extraction can be performed before lens luxation becomes an issue in that eye also. The chance of developing cataracts may be reduced with changes in your dog’s diet to include substances such as beta carotene. If caught early, medical management of cataracts or glaucoma to prevent the condition progressing, and possibly lens luxation from occurring, may be possible.