Reassessing Antibiotic Use in Canine and Feline Eyelid and Third Eyelid Surgeries: An Observational Study Supporting Selective Prophylaxis.

Selective prophylactic antibiotic protocols in eyelid surgery reduce unnecessary antimicrobial use without increasing complications.

This observational study evaluated postoperative outcomes in 96 animals (71 dogs, 25 cats) undergoing 163 eyelid and third eyelid procedures with a selective prophylactic antibiotic approach. Animals were stratified into four groups based on antibiotic administration: none (70 animals), topical only (12), systemic only (4), and combined (9). Prophylactic antibiotics were reserved for cases meeting predefined criteria including prolonged surgery, aseptic protocol breach, comorbidities, or concurrent otitis/dermatitis. Postoperative complications were graded using the adapted Clavien-Dindo system. Only two grade II complications (suture dehiscence) occurred: one in a cat receiving combined antibiotics post-Read and Broun procedure, and one in a dog without antibiotics post-bilateral Kuhnt-Szymanowski procedure. Both resolved with medical management. The findings suggest that withholding routine prophylactic antibiotics in eyelid and third eyelid surgery does not increase postoperative complication rates when selective criteria-based protocols are implemented, supporting antimicrobial stewardship in veterinary ophthalmology.

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