Dr. Felipe Wouk

Dr. João Alfredo Kleiner

AUTOTRANSPLANTATION OF THE

RECURRENTLY PROLAPSED THIRD EYELID

GLAND IN DOGS

• “Cherry-eye”

• Most common primary disorder of

the nictitating membrane

• Generally before 2 years of age

• Weakness in the connective tissue

PROLAPSE OF THE GLAND

• Predisposition in:

• American Cocker Spaniel

• Lhasa Apso

• Pekingese

• Beagle

• English Bulldogs

• Cane Corso

PROLAPSE OF THE GLAND

• Surgical replacement of the gland is indicated (Helper et al, 1974; Chang & Lin, 1980)

• Several procedures

• Anchor

• Pocket

• Lower incidence of KCS than dogs not treated and those where the gland is excised.

(Morgan et al, 1993)

PROLAPSE OF THE GLAND

• Recurrence of third eyelid gland

prolapse after surgery occurs in

5 - 10 % of cases.

• Re-operation is not always

possible and have a lower

success rate.

OBJECTIVES

• Evaluation of the clinical effects of autotransplantation of

part of the third eyelid gland into the conjunctival fornix

• Alternative means of maintaining the harmony of the

preocular tear film

• Gland produces 30 to 50% of the aqueous part of the

precorneal tear film.

METHODS

• 8 dogs (different breeds)

• Presenting with recurrent prolapsed gland of the third

eyelid

• Complete ophthalmic exam prior and 3 months after the

autotransplant

SURGICAL TECHNIQUE

• Excision of the third eyelid gland

• Graft preparation using the middle 1/3 portion of the

excised gland

• Construction of a pocket within the superior temporal

conjunctival fornix

• Suturing using 6-0 vicryl

RESULTS

• Conjunctival hyperemia resolved in 98 % of the cases.

• Corneal Neovascularization and Blepharospasm

resolved in 100 % of the cases.

• Corneal Luster restored in 99 %.

SCHIRMER TEAR TEST (STT)

56.3 % increasing in STT !!

Before the surgery 90 days after the procedure

CONCLUSIONS

• The prolapsed third eyelid gland have a very low function

because of the inflammation

• When you replace it, the gland starts to work well again

• The same happen with the autotransplantation.

CONCLUSIONS

• All patients showed clinical improvement following surgery.

• Technique is quite easy to perform.

• Appears to be an alternative option in cases of recurrence

after surgical replacement of the third eyelid lacrimal gland.

ACKNOWLEDGMENTS:

Dr. Felipe Wouk Dr. Akihiko Saito

Any Questions ? ? ?