Recurrence of third eyelid gland prolapse after surgical replacement occurs in 5-10% of cases. Re-operation is not always possible and re-operated cases are not always successful. This video shows an autotransplantation of part of the third eyelid gland into the conjunctival fornix as an alternative means of maintaining the aqueous tear film in patients with recurrence of glandular prolapse after surgical replacement using a pocket technique. Surgeon: Dr. João Alfredo Kleiner DVM, MSc. Vetweb Oftalmologia Veterinária.

2. AUTOTRANSPLANTATION OF THE
RECURRENTLY PROLAPSED THIRD EYELID
GLAND IN DOGS
Dr. Felipe Wouk
Dr. João Alfredo Kleiner

3. PROLAPSE OF THE GLAND
• “Cherry-eye”
• Most common primary disorder of
the nictitating membrane
• Generally before 2 years of age
• Weakness in the connective tissue

4. PROLAPSE OF THE GLAND
• Predisposition in:
• American Cocker Spaniel
• Lhasa Apso
• Pekingese
• Beagle
• English Bulldogs
• Cane Corso

5. 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)

6. • 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.

7. 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.

8. METHODS
• 8 dogs (different breeds)
• Presenting with recurrent prolapsed gland of the third
eyelid
• Complete ophthalmic exam prior and 3 months after the
autotransplant

9. 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

10. RESULTS
• Conjunctival hyperemia resolved in 98 % of the cases.
• Corneal Neovascularization and Blepharospasm
resolved in 100 % of the cases.
• Corneal Luster restored in 99 %.

11. SCHIRMER TEAR TEST (STT)
56.3 % increasing in STT !!

12. Before the surgery 90 days after the procedure

13. 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.

14. 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.

15. ACKNOWLEDGMENTS:
Dr. Felipe Wouk Dr. Akihiko Saito

16. Any Questions ? ? ?