Detailed Explanation of the Surgical Procedure for Canine Third Eyelid Polyp Removal
Canine third eyelid polyp, also known as "cherry eye," is an eye disease in which the gland, due to hypertrophy and other reasons, together with the nictitating membrane, flips outward from inside the eye and becomes inflamed, causing increased eye discharge and presenting symptoms of conjunctivitis. Superficial nictitating membrane gland hypertrophy is commonly seen clinically, and it can occur in one eye or both eyes. It is a common eye disease among pet surgical conditions. Conventional treatment with eye drops, eye ointments, and antibacterial drugs often proves ineffective, while surgical excision yields satisfactory results and does not recur. In clinical work, more than 20 cases of this disease have been encountered, all of which were treated with surgical excision for one-time cure with remarkable results. The surgical method is briefly described below.
1 Etiology
It is mainly caused by the abundant blood supply to the nictitating membrane and excessive glandular secretion, secondary to orbital cellulitis, poorly developed gland attachment ligaments, or defects in the third eyelid gland cartilage, and may be related to genetics.
2 Symptoms
Serous or viscous eye discharge is secreted, and an abnormal nictitating membrane protrudes at the inner corner of the eye. Due to long-term exposure, the gland becomes congested, swollen, and epiphora occurs, with the protruding mass appearing dark red and ulcerated. In dogs with more severe nictitating membrane hypertrophy, the entire nictitating membrane becomes red and enlarged, and the exposed nictitating membrane covers part of the eyeball, accompanied by ocular movement disorder and difficulty with vision.
3 Treatment Methods
Drug treatment is ineffective for this disease; only surgical excision is effective.
3.1 Surgical instruments: small curved hemostatic forceps, tweezers, scalpel or curved scissors, cotton balls, eye drops, epinephrine, anesthetic 846 mixture.
3.2 Anesthesia: 846 mixture is injected intramuscularly at 0.1 mL/kg. Preoperative fasting for 12 h is required, because most affected dogs will experience vomiting and other allergic reactions after intramuscular injection of 846. About 15 min after intramuscular injection, the affected dog will protrude its tongue and breathe slowly; at this point it has entered the anesthetized state and surgery can be performed.
3.3 Surgical method: Place the affected dog in lateral recumbency on the operating table, and rinse the exterior with normal saline to prevent postoperative infection. Use small curved hemostatic forceps to clamp tightly at the base of the protruding mass and excise it, then apply pressure for a period of time, about 5 min. If there is bleeding, use cotton balls soaked in epinephrine to apply pressure at the incision surface to stop the bleeding, or drip 2 to 3 drops of 0.1% epinephrine solution onto the incision, then gently open the hemostatic forceps. After surgery, antibiotic eye drops or eye ointments should be applied to the affected eye 2 to 3 times daily for one week. Postoperative care should be performed well to prevent scratching or rubbing of the surgical site. To prevent infection, antibiotics may be appropriately injected intramuscularly after surgery, and recovery can be achieved in about 5 d after surgery.