Update on surgical cosmetic solutions in equine ophthalmology.
Authors: Jarry J, Dugdale A, Vandeweerd J M
Journal: Journal of equine veterinary science
Summary
# Editorial Summary When enucleation becomes necessary in equine practice, several surgical cosmetic alternatives now exist to restore appearance and function, yet evidence supporting their relative merits remains scattered across the literature. Jarry and colleagues conducted a systematic review of peer-reviewed publications and congress proceedings to synthesise current best practice on equine ophthalmic prosthetics, identifying 17 primary studies (predominantly retrospective case series and reports) that evaluated cosmetic outcome, functional recovery, owner satisfaction, complication rates, and implant longevity. Intrascleral prostheses and intraorbital implants combined with a corneoscleral shell demonstrated superior cosmetic results compared to other options, whilst orbital meshwork implants require further refinement to achieve acceptable aesthetics; importantly, return to work proved feasible across most cases, with standing sedation offering a practical alternative to general anaesthesia for implant placement beneath sutured eyelids. The emergence of 3D printing technology presents significant scope for personalised implant design and improved biocompatibility, potentially reducing complications and enhancing long-term outcomes. For equine practitioners, this review emphasises that post-enucleation cosmetic restoration is not merely aesthetic—it represents a meaningful opportunity to preserve function and owner satisfaction, though implant selection should be guided by individual case factors, cost considerations, and realistic discussion of both complication rates and revision surgery possibilities.
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Practical Takeaways
- •If recommending post-enucleation cosmetic solutions, intrascleral prosthesis or intraorbital implants with corneoscleral shells provide best cosmetic results and owner satisfaction
- •Horses receiving orbital implants can return to work, and standing sedation is a viable option for surgical placement, improving practicality for equine patients
- •Orbital meshwork implants are currently not recommended due to poor cosmetic acceptance; avoid suggesting this option until further improvements are made
Key Findings
- •Intrascleral prosthesis and intraorbital implants with corneoscleral shells demonstrate superior cosmetic outcomes compared to other solutions
- •Orbital meshwork implants require further development to achieve cosmetically acceptable results
- •Return to work is feasible following orbital implant placement using standing sedation technique
- •3D printing technology offers new possibilities for customized implant design and development