Surgical Correction of Prolapse of Nictitating Membrane Gland Using a Variant of the Pocket Technique: A Retrospective Study on 101 Dogs and 126 Eyes.

Objective: To retrospectively investigate the outcome of a modified Morgan pocket technique that included temporary ventral scleral gland fixation to treat prolapse of the nictitans gland.

Animal studied: The files of 101 client-owned dogs (126 eyes) between 2015 and 2024 were retrospectively analyzed.

Results: All the surgeries were completed in under 10 min. Follow-up was between 180 to 3285 days (mean 1190 days) in 119/126 (94%) eyes and three years in 81/126 (64.3%) eyes. The technique achieved successful surgical repositioning in 125/126 (99.2%) eyes after one surgery, with only one eye (1/126 (0.8%)) having a recurring prolapse that was successfully managed by repeating the technique. Seven other immediate postoperative complications (7/126, 5.6% of the eyes) were recorded, including lacrimal cysts in 5/126 (4%) eyes and corneal ulceration in 2/126 (1.6%) eyes. All cysts were treated with local drainage, two under general anesthesia and three under sedation and topical anesthesia. Additional complications occurred in 14/101 (13.9%) of the animals, including keratoconjunctivitis sicca and ulcerative keratoconjunctivitis of different degrees of severity. Given the long follow-up and low number of cases affected, it was not known if these problems might have been associated with some aspects of the surgical treatment.

Conclusions: The technique described included a temporary fixation of the gland before closure of the pocket with successful long-term repositioning of the gland in 99.2% of eyes after the first attempt. Cysts and recurrence were infrequent complications. Further studies could investigate if the technique might be adapted to minimize complications.