Primary entropion in persian cats 1999 José Luiz Laus.pdf

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ISSN0103-8478
PRIMARYENTROPIONINPERSIANCATS
ENTRÓPIOPRIMÁRIOEMGATOSPERSAS
JoséLuizLaus1FelipeAntônioMendesVicenti2IviaCarmenTalieri2
AdrianaTorrecilhasJorge2AlineAdrianaBolzan2
-CASESREPORT-
RESUMO(freqüentementeaporçãolateraldapálpebrainferior)atritama
cóçãopodesercongênita,espástica
çausualmentecausaepífora,blefaros-
eyelidmargininwhichtheeyelashesandeyelidhair(frequentlypasmo,fotofobia,conjuntivite,secreçãopurulenta,vasculariza-
thelowerlaterallid)ção,pigmentaçãoeulceraçãocorneanas,senãofortratada
congenital,spastic,ópiocongênitocomumenteafetacãese
epiphora,blepharospasm,photophobia,conjunctivitis,purulentfreqüentementeéhereditárioemalgumasraças,enquantoqueos
discharge,cornealvascularization,pigmentationandulceration,gatosraramentesãçãodaraça
ó-
dogsandisfrequentlyhereditaryinsomebreeds,whereascatspiofelinoencaminhadosaoSetordeOftalmologiadaFaculdade
ênciaseVeterináriasdaUniversidadeEstadualPaulista–
,Jaboticabal–SP/:felinomacho,
reporttwocasesofentropioninPersiancatsreferredtothedaraçaPersa,comdoisanosdeidadeehistóricodeirritação
OphthalmologySectionofVeterinaryCollegeofSãoPauloStateocularbilateralesecreçã
University-UNESP,Jaboticabal-SP/:amaleoftálmico,observou-seepífora,blefarospasmo,fotofobia,entró-
Persiancat,2yearsold,withahistoryofbilateralocularpiobilateral,oqualafetavatodaaextensãodaspálpebrasinferi-
,conjuntiviteesecreçã:felino
examinationrevealedepiphora,blepharospasm,photophobia,macho,daraçaPersa,com1anodeidadeehistóricodeirrita-
bilateralentropionaffectingthewholelengthofthelowereyelids,çãoocularbilateralesecreçã
:amaleexameoftálmico,oanimalapresentavaepífora,blefarospasmo,
Persiancat,1yearold,withahistoryofbilateralocularfotofobia,entrópiobilateral,oqualafetavatodaaextensãodas
álpebrasinferiores,conjuntivite,secreçãopurulenta,vasculari-
examinationtheanimalwaspresentingepiphora,blepharospasm,zaçãocorneana,ulceraçã
photophobia,bilateralentropionaffectingthewholelengthofthecirúrgicoempregadofoisimilaremambososcasosbaseando-se
lowerlids,conjunctivitis,purulentdischarge,cornealnatécnicadeHoltz-
vascularization,ção
ínicasatisfatória,confirmadapoucosdiasapósacirurgia.
wassimilarinbothcases,basedonthemodifiedHoltz-Celsus
-chave:pálpebras,entrópio,gatos.

wasconfirmedfewdaysaftersurgery.
Keywords:eyelids,entropion,
Entropionisacommoneyeliddisorderin
RESUMOdogs,
Oentrópioécaracterizadoporumainversãodaofaturningoftheeyelidmargininwhichthe
margempalpebral,naqualoscílioseospêlosdapálpebraeyelashesandeyelidhairirritatethecorneacausing
1AssociateProfessor,DVM,PhD.,OphthalmologySection,VeterinaryCollege,SãoPauloStateUniversity,RodoviaCarlosTonanni,
Km5,14870-000,Jaboticabal,SP--mail:******@ência.
2GraduateStudents,OphthalmologySection,VeterinaryCollege,SãoPauloStateUniversity.
Recebidoparapublicaçã
738Lausetal.
epiphora,blepharospasm,photophobia,conjunc-CollegeofSãoPauloStateUniversity-UNESP,
tivitisandpurulentdischarge,cornealJaboticabal-SP/:amalePersian
vascularization,pigmentationandulcerationifnotcat,twoyearsold,withahistoryofbilateralocular
surgicallytreated(HELPER,1989;SLATTER,
1990b;GELATT,1991b;PETERSEN-JONES,ophthalmicexaminationshowedepiphora,
1993).blepharospasm,photophobia,severebilateral
Theetiologiesofthisconditionmaybeentropionaffectingthewholelengthofthelower
congenital,spastic,acquired,orcicatricialeyelids,conjunctivitisandpurulentdischarge(figure
(HELPER,1989;SLATTER,1990b;GELATT,1).Agreatamountofskinontheoutersurfaceof
1991b).
relationship,andthetoneoftheorbicularisoculieyelidsurfacewaswhitefromconstantcontactwith
,
lessthanoptimalglobeposition,

(GELATT,1991b;PETERSEN-JONES,1993).proceduresforsurgery,theanimalwastakenintothe
Congenitalentropioncommonlyaffectsdogsanditsurgicalcenterandsubmittedtoinhalatory
isfrequentlyaninheriteddiseaseinsomebreeds,anaesthesiabyemployinghalothaneainaclosed
suchasChow-chow,Shar-pei,
AmericanCockerSpaniel,EnglishBulldog,Toyandstripoftheorbicularisoculimusclewereexcised
MiniaturePoodles,,GreatDanesandusingsharp,
BullMastiff(SLATTER,1990b;GELATT,1991b).
with4-0Vicrylbwerecarefullyplacedthrougththe
Thelateralpartofbothlowereyelidsareusually
skin,perpendiculartothewoundmarginsand1to2
affected(SLATTER,1990b).
Spasticentropionindogsusuallyoccursmmfromtheeyelidmargin.
:amalePersiancat,oneyear
toneandspasmoftheorbicularisoculimuscleold,withthehistoryofbilateralocularirritationand
increaseseyelidmargininversion(SLATTER,
1990b;GELATT,1991b).Cicatricialentropionmayexaminationtheanimalpresentedepiphora,
becausedbyfibrosisrelatedtosurgery,traumaandblepharospasm,photophobia,severebilateral
chronicinflammatoryprocesses(GELATT,1991b).entropionaffectingthewholelengthofthelower
Althoughcicatricialentropiondoesoccur,eyelids,conjunctivitis,purulentdischarge,corneal
felineentropionisfrequentlysecondarytopainfulvascularization,superficialulceration,andedema
oculardiseasesthatcausechronicblepharospasm(figure2).Clinicalsignsweremoreevidentdueto
(SLATTER,1990b;NASISSE,1991).
tendencyoftheeyelidinversiontobecametopicalanaesthesiatheeyeliddefectalsopersisted.
permanent,thistypeofentropionmightbedescribedModifiedHoltz-Celsusandgridkeratotomy
asspastic-cicatricial(NASISSE,1991)Inspiteof
thelowprevalenceofeyelidsdiseasesincats,
primaryentropiondoesoccurwithapredilectionfor
thePersianbreed(SLATTER,1990b;NASISSE,
1991).Thesurgicalcorrectionbasedonthemodified
Holtz-Celsustechniqueistheprocedureofchoice
fortreatingfelineentropion(NASISSE,1991;
PETERSEN-JONES,1993).
Thelowprevalenceoffelineentropion,
theimportanceonthepathophysiologicalevolution
inprimaryentropionandsuccessofsurgical
treatmentinthesetwocasesmotivatedtheauthorsto

emphasizethepredilectionforthePersianbreedto
presentprimaryentropionandalsotorelateits
clinicalpresentation.
Figure1-Firstcase:epiphora,blepharospasm,severebilateral
CASESREPORTentropionaffectingthewholelengthofthelowereye-
lidsandpurulentdischargeinamalepersiancat,two
yearsoldpresentedtotheophtalmologysectionofCe-
TwocasesofentropionincatswereterinaryCollegeofSãoPauloStateUniversity-
referredtotheOphthalmologySectionofVeterinaryUNESP-Jaboticabal-SP/Brazil.
CiênciaRural,,,1999.
Primaryentropioninpersiancats739
Figure2-Secondcase:epiphora,blepharospasm,severebilateralFigure3-Firstcase:
entropionaffectingthewholelengthofthelowereye-marginsrestorednormalrelationshiptotheglobeand
lidsandpurulentdischargeinamalePersiancat,onenormalpalpebralfissurewithnosignofocular
yearoldpresentedtotheophtalmologysectionofCete-irritationinthetwoyearsoldmalepersiancat.
rinaryCollegeofSãoPauloStateUniversity-UNESP-
Jaboticabal-SP/Brazil.
amountofinrolledeyelidsshowedattheophthalmic
examinationofthecasesherepresented.
-Celsustechniquewas
thelowereyelidskin-muscleresectionweresimilareasilyperformedandeffectiveforcorretingfeline
,whichwasverified15daysaftersurgery.
PostoperativetreatmentconsistedofBothcasesmaybeconsideredprimary
topicalapplicationof0,5to1cmofophthalmic
cfelineentropion,althoughthistypeofstructural
ointment(Epitezan®)placedoverthesurgicaldefectrarelyoccursincats(NASISSE,1991).The
woundsandintotheconjunctivalsacofeacheyeat
intervalsof8hoursduring10daysanduseofan
Elizabethancollar.
RESULTSANDDISCUSSION
Thelowprevalenceoffelineentropionis
(1972)
describedjustonecaseofentropionfromatotalof
&SZUCS
(1986)reported10casesofentropionfromatotalof
145catspresentingdifferenteyeconditions.
Clinicalevolutionofbothcaseswere
observedat1,15,30,45and60daysfollowing

-Secondcase:
restorednormalrelationshiptotheglobeandnormalmarginsrestorednormalrelationshiptotheglobeand
palpebralfissurewithnosignofocularirritationnormalpalpebralfissurewithnosignofocularirrita-
(figure3andfigure4).tionintheoneyearoldmalepersiancat.
Thereareinformationthatsuggestthechronicblepharospasmandocularirritationwas
predilectionforPersianbreedtopresentprimaryinducedbytheentropion,consideringthatbothcats
entropion(SLATTER,1990b;NASISSE,1991).inthisstudyhadnohistoryoftraumaorovert
Consideringourcasuistry,
,theentropionpersistedaftertopical
STADESetal(1992)observedinbreedsanaesthesiaandreliefoftheblepharospastic
frequentlyaffected,
Flandres,LabradorandGoldenRetriever,andincreasedspasticblepharospasmandocular
Persiancat,
.
CiênciaRural,,,1999.
740Lausetal.
Theulcerwassuperficial,withaPhiladelphia:Lea&Febiger,:Diseasesand
nonadherentlipofepitheliumaroundtheulcer’ssurgeryofthelidsandlacrimalapparatus:-89.
,.,CRISPIN,:
ofrefractorycornealulcer(WHITLEY,1991).PETERSON-JONES,.,CRISPIN,
Inthesecondcase,:BritishSmallAnimal
,1993,,-43.
epitheliumwasremovedwithacottonswabrubbedMORGAN,.,ABRAMS,
overtheedgeofthecorneallesionandaffectedarea,therapiesforpersistentcornealerosionsindogsandcats.
andahipodermicneedlewasusedtomakescratchesVeterinaryandComparativeOphthalmology,,,p.
38-43,1994.
overtheulcersite,exposingnormalcornealstroma
(WHITLEY,1991).KeratotomyisthemostNASISSE,:GELATT,.
:Lea&
(MORGAN&ABRAMS,1994;STADSVOLD,Febiger,,-575.
1995).AccordingtoSLATTER(1990a);GELATTPETERSEN-JONES,
(1991a)andHOPPER&CRISPIN(1993),:PETERSEN-JONES