Complications associated with subpalpebral lavage systems in upper and lower equine eyelids: A prospective, randomised study in 73 cases (2015-2024).
Abstract: Evidence for optimal location of subpalpebral lavage (SPL) systems is lacking. Objective: To compare the rate and types of complications with SPL systems located in central upper- compared with medial lower-eyelid in hospitalised patients. Methods: 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. Conclusions: 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.
© 2025 The Author(s). Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
Publication Date: 2025-06-26 PubMed ID: 40567141DOI: 10.1111/evj.14540Google Scholar: Lookup
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Summary
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This study compared complications in horses from subpalpebral lavage (SPL) systems placed in different locations in the eye. The results showed that while the location of the SPL system did not overall affect the rate of complications, major complications were more frequent in SPL systems placed in the upper eyelid.
Objective and Methods
- The goal of this research was to determine whether the placement of a subpalpebral lavage (SPL) system in the upper or lower eyelid of a horse affected the rate and types of complications resulting from such placement.
- This was a prospective, randomized treatment trial that included horses that were admitted for eye treatments needing an SPL system. A coin toss determined whether the SPL system would be placed in the upper or lower eyelid. The SPL systems were monitored daily.
- Major complications were classified as displacement of the footplate, corneal ulceration, loss of footplate, and eyelid infection/abscess formation. Minor issues included loss of suture/tape, palpebral swelling, leakage or tube rupture, loss of injection port, and subcutaneous swelling/abscess at the suture site.
- Data from a total of 73 SPL systems implemented in 68 horses were analyzed using logistic regression.
Results
- The results showed that 44 of the 73 systems (60%) experienced complications. Out of these, 37 were in upper eyelid systems and 32 in lower eyelid systems.
- Major complications were more frequent in upper eyelid SPL systems (14% vs. 3%). The most common major complication was displacement of the lavage footplate from the conjunctival fornix.
- On the contrary, the most usual minor complication was loss of suture or butterfly tape.
- It was also noticed that the use of chloramphenicol decreased the probability of any complication, while the application of cross-linked modified hyaluronic acid increased the likelihood of any complication.
Conclusions
- While the study size was rather small, the results indicated that the location of the SPL system does not affect the overall complication rates.
- However, upper eyelid SPL systems were associated with a higher probability of experiencing major complications in comparison to lower eyelid SPL systems.
Cite This Article
APA
Graham AE, Carslake HB, Malalana F.
(2025).
Complications associated with subpalpebral lavage systems in upper and lower equine eyelids: A prospective, randomised study in 73 cases (2015-2024).
Equine Vet J.
https://doi.org/10.1111/evj.14540 Publication
Researcher Affiliations
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK.
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK.
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK.
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