EXPRESS: Treatment rationales and outcomes for cats with lens luxation: 136 eyes (2007-2023)

OBJECTIVES: To evaluate outcomes in cats with lens luxation treated with intracapsular lens extraction (ICLE), medical management, or transcorneal lens reduction (TCLR), and to investigate reasoning behind treatment recommendations. METHODS: Medical records were retrospectively reviewed to identify cats with lens luxation. Data collected included signalment, examination findings, treatment decision and rationale for treatment, and outcome. RESULTS: Records were reviewed for 136 eyes from 115 cats. Male cats (77%) were overrepresented. 83/136 (61%) of eyes were nonvisual on presentation. Medical management was initially elected for 79/136 (58%) of eyes, enucleation for 32/136 (24%), ICLE for 12/136 (9%), and TCLR for 7/136 (5%), while no treatment was elected for 3/136 eyes (2%), 2 cats were euthanized (2/136 eyes, 1%), and one eye underwent diode laser cyst ablation. TCLR was not successful in any eyes. Of eyes with followup, 12/13 (92%) eyes that underwent ICLE as primary or secondary management were visual and normotensive (IOP <25 mmHg), while 19/50 (38%) medically managed eyes were visual and normotensive. However, 33/50 (66%) of medically managed eyes were normotensive at last recheck and 17/23 (74%) of medically managed eyes that were visual on presentation remained visual at last recheck. Treatment rationale was noted for 91 eyes. Factors cited included visual status (40%), perceived comfort (36%), age or medical history (29%), financial limitations (12%), inability to medicate (10%), other ocular examination findings (9%), and potential risk of feline post-traumatic ocular sarcoma following ICLE (7%). CONCLUSIONS AND RELEVANCE: TCLR does not appear to be a viable treatment modality in cats. Medical management of lens luxation may produce acceptable results for IOP control and retention of vision when ICLE is not possible. Providing cat owners with accurate information about outcomes and financial implications of treatment options for lens luxation is critical.