Annabelle E Graham, Harry B Carslake, Fernando Malalana
{"title":"马上下眼睑眼睑下灌洗系统相关并发症:一项73例前瞻性随机研究(2015-2024)。","authors":"Annabelle E Graham, Harry B Carslake, Fernando Malalana","doi":"10.1111/evj.14540","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Evidence for optimal location of subpalpebral lavage (SPL) systems is lacking.</p><p><strong>Objectives: </strong>To compare the rate and types of complications with SPL systems located in central upper- compared with medial lower-eyelid in hospitalised patients.</p><p><strong>Study design: </strong>Prospective, randomised treatment trial.</p><p><strong>Methods: </strong>Horses admitted for ophthalmic treatment using an SPL system from February 2015 to January 2024 were included if ocular pathology did not necessitate SPL system placement in a specific location. Coin toss was used to determine location. SPL systems were monitored at least daily, and complications were defined as major (displacement of footplate from the fornix ± corneal ulceration; loss of footplate; eyelid infection/abscess formation) or minor (loss of suture/tape; palpebral swelling; leakage or tube rupture; loss of injection port; subcutaneous swelling/abscess at suture site). Data were analysed using logistic regression.</p><p><strong>Results: </strong>Seventy-three SPL systems in 68 horses were included, with 38 (52%) located in the upper and 35 (48%) in the lower eyelid, for a median (IQR) duration of 13 (8-16) days. Sixty-nine complications (37 (54%) in upper and 32 (46%) in lower SPL systems) occurred in 44/73 (60%) of all SPL systems. Major complications occurred with 2 lower (2/69; 3%) and 10 upper SPL systems (10/69;14%). The most common major complication was displacement of the lavage footplate from the conjunctival fornix (7/69; 10%). The most common minor complication was loss of suture or butterfly tape (21/69; 30%). Treatment with chloramphenicol (OR = 0.3; 95% CI: 0.09-0.8; p = 0.02) or cross-linked modified hyaluronic acid (OR = 3.9; 95% CI: 1.2-13.3; p = 0.03) was associated with any complication on multivariable analysis. Multivariable analysis showed that upper systems were 5.1 (95% CI: 1.0-25.7; p = 0.05) more likely to have a major complication than lower SPL systems.</p><p><strong>Main limitations: </strong>Small study size.</p><p><strong>Conclusions: </strong>SPL system location had no effect on all complications, but major complications were more common in those placed in the upper lid.</p>","PeriodicalId":11796,"journal":{"name":"Equine Veterinary Journal","volume":" ","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Complications associated with subpalpebral lavage systems in upper and lower equine eyelids: A prospective, randomised study in 73 cases (2015-2024).\",\"authors\":\"Annabelle E Graham, Harry B Carslake, Fernando Malalana\",\"doi\":\"10.1111/evj.14540\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Evidence for optimal location of subpalpebral lavage (SPL) systems is lacking.</p><p><strong>Objectives: </strong>To compare the rate and types of complications with SPL systems located in central upper- compared with medial lower-eyelid in hospitalised patients.</p><p><strong>Study design: </strong>Prospective, randomised treatment trial.</p><p><strong>Methods: </strong>Horses admitted for ophthalmic treatment using an SPL system from February 2015 to January 2024 were included if ocular pathology did not necessitate SPL system placement in a specific location. Coin toss was used to determine location. SPL systems were monitored at least daily, and complications were defined as major (displacement of footplate from the fornix ± corneal ulceration; loss of footplate; eyelid infection/abscess formation) or minor (loss of suture/tape; palpebral swelling; leakage or tube rupture; loss of injection port; subcutaneous swelling/abscess at suture site). Data were analysed using logistic regression.</p><p><strong>Results: </strong>Seventy-three SPL systems in 68 horses were included, with 38 (52%) located in the upper and 35 (48%) in the lower eyelid, for a median (IQR) duration of 13 (8-16) days. Sixty-nine complications (37 (54%) in upper and 32 (46%) in lower SPL systems) occurred in 44/73 (60%) of all SPL systems. Major complications occurred with 2 lower (2/69; 3%) and 10 upper SPL systems (10/69;14%). The most common major complication was displacement of the lavage footplate from the conjunctival fornix (7/69; 10%). The most common minor complication was loss of suture or butterfly tape (21/69; 30%). Treatment with chloramphenicol (OR = 0.3; 95% CI: 0.09-0.8; p = 0.02) or cross-linked modified hyaluronic acid (OR = 3.9; 95% CI: 1.2-13.3; p = 0.03) was associated with any complication on multivariable analysis. Multivariable analysis showed that upper systems were 5.1 (95% CI: 1.0-25.7; p = 0.05) more likely to have a major complication than lower SPL systems.</p><p><strong>Main limitations: </strong>Small study size.</p><p><strong>Conclusions: </strong>SPL system location had no effect on all complications, but major complications were more common in those placed in the upper lid.</p>\",\"PeriodicalId\":11796,\"journal\":{\"name\":\"Equine Veterinary Journal\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-06-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Equine Veterinary Journal\",\"FirstCategoryId\":\"97\",\"ListUrlMain\":\"https://doi.org/10.1111/evj.14540\",\"RegionNum\":2,\"RegionCategory\":\"农林科学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"VETERINARY SCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Equine Veterinary Journal","FirstCategoryId":"97","ListUrlMain":"https://doi.org/10.1111/evj.14540","RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"VETERINARY SCIENCES","Score":null,"Total":0}
Complications associated with subpalpebral lavage systems in upper and lower equine eyelids: A prospective, randomised study in 73 cases (2015-2024).
Background: Evidence for optimal location of subpalpebral lavage (SPL) systems is lacking.
Objectives: To compare the rate and types of complications with SPL systems located in central upper- compared with medial lower-eyelid in hospitalised patients.
Study design: Prospective, randomised treatment trial.
Methods: Horses admitted for ophthalmic treatment using an SPL system from February 2015 to January 2024 were included if ocular pathology did not necessitate SPL system placement in a specific location. Coin toss was used to determine location. SPL systems were monitored at least daily, and complications were defined as major (displacement of footplate from the fornix ± corneal ulceration; loss of footplate; eyelid infection/abscess formation) or minor (loss of suture/tape; palpebral swelling; leakage or tube rupture; loss of injection port; subcutaneous swelling/abscess at suture site). Data were analysed using logistic regression.
Results: Seventy-three SPL systems in 68 horses were included, with 38 (52%) located in the upper and 35 (48%) in the lower eyelid, for a median (IQR) duration of 13 (8-16) days. Sixty-nine complications (37 (54%) in upper and 32 (46%) in lower SPL systems) occurred in 44/73 (60%) of all SPL systems. Major complications occurred with 2 lower (2/69; 3%) and 10 upper SPL systems (10/69;14%). The most common major complication was displacement of the lavage footplate from the conjunctival fornix (7/69; 10%). The most common minor complication was loss of suture or butterfly tape (21/69; 30%). Treatment with chloramphenicol (OR = 0.3; 95% CI: 0.09-0.8; p = 0.02) or cross-linked modified hyaluronic acid (OR = 3.9; 95% CI: 1.2-13.3; p = 0.03) was associated with any complication on multivariable analysis. Multivariable analysis showed that upper systems were 5.1 (95% CI: 1.0-25.7; p = 0.05) more likely to have a major complication than lower SPL systems.
Main limitations: Small study size.
Conclusions: SPL system location had no effect on all complications, but major complications were more common in those placed in the upper lid.
期刊介绍:
Equine Veterinary Journal publishes evidence to improve clinical practice or expand scientific knowledge underpinning equine veterinary medicine. This unrivalled international scientific journal is published 6 times per year, containing peer-reviewed articles with original and potentially important findings. Contributions are received from sources worldwide.