Regional Veterinary Surgery

NICTITANS MEMBRANE GLAND

• The gland of the third eyelid surrounds the base of the T-shaped cartilage.
  • T – Cartilage forms the skeleton of the third eyelid.
  • This gland contributes to the aqueous and mucus phases of the precorneal tear film.
  • This is important in maintaining a healthy ocular surface.

Affections of nictitans gland and its treatment 

Prolapsed nictitans gland

• The resulting characteristic appearance of a pink, smooth – surfaced swelling protruding around the leading edge of the third eyelid from its inner surface.

Prolapse of the nictitans gland

• Dogs treated with surgical replacement of the gland have a lower incidence of dry eye later in life than dogs that are either left untreated or have the prolapsed gland excised.

Surgical procedure

• Orbital rim anchorage technique
  • The eyeball was fixed and it is flushed with a dilute Povidone Iodine
  • An incision is made in the medio ventral conjunctival fornix using scissors.
  • Blunt dissection allows access to the periosteum of the medioventral orbital rim.
  • A firm bite of periosteum along the orbital rim is taken using 3 – 0 PDS.
  • The needle is passed dorsally through the most prominent of prolapsed gland.
  • Horizontal bite is taken through the dorsal prominence of the gland.
  • Finally the needle is passed back through the last exit hole to emerge through the original incision thus encircling a large portion of the gland.
  • The suture ends are then tied.
  • Post operatively topical antibiotic is given.
• Conjunctival pocketing technique
  • The eyeball was fixed and it is flushed with a dilute Povidone Iodine
  • An elliptical incision is made in the apex of the prolapsed gland with a No 11 BP blade and  using scissors  blunt dissection is performed and the conjunctival piece is dissected out. Further a pocket is made around the gland  and the prolapsed gland is repositioned in to this pocket. Continous sutures are applied using 4-0 vicryl taking care to burry the suture ends.

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