ArticleEquine veterinary journal2026
Complications associated with subpalpebral lavage systems in upper and lower equine eyelids: A prospective, randomised study in 73 cases (2015-2024).
Article in Equine veterinary journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundEvidence for optimal location of subpalpebral lavage (SPL) systems is lacking.
objectivesTo compare the rate and types of complications with SPL systems located in central upper- compared with medial lower-eyelid in hospitalised patients. STUDY
designProspective, randomised treatment trial.
methodsHorses 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.
resultsSeventy-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.
conclusionsSPL system location had no effect on all complications, but major complications were more common in those placed in the upper lid.
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