Plummer, CE, Kallberg, Me, Gelatt, Kn, Barrie,

Plummer, CE, Kallberg, ME, Gelatt, KN, Barrie, KP, and Brooks, DE. 2008. Intranictitans tacking for replacement of prolapsed gland of the third eyelid in dogs. Veterinary Ophthalmology. 11(4): 228-233.

A common disorder in dogs is called the prolapse of the gland of the third eyelid. This disorder appears as a lump of red tissue extending beyond the leading edge of the nictitans; a translucent third eyelid inherent in some animals, including dogs. The gland slips loose from it's original position and, as it exposes itself, becomes inflamed. There are currently two surgical procedures veterinarians commonly use to treat such conditions: either to remove the gland, or to cut out a crevice, stick the gland into the crevice, and then suture, or stitch, it to keep it in place. Either procedure will cause some damage to the eyelid as well as interfere with the glands ability to produce tear fluid needed for protection and lubrication of the eye. The authors of the paper have developed a new surgical technique for treating a prolapse of the gland of the third eyelid; one that has been demonstrated to keep the gland in place while not interfering with the gland's ability to produce tear fluid. Therefore, the author's new technique is a better treatment for this disorder.

There really is not an experiment described in this paper, instead a new technique is being tested. The previous techniques used to treat this disorder, and the authors go into great detail to describe the exact surgical procedures, often left the dog either with no gland, or the gland stuck into the tissue and sutured shut. With the gland removal procedure there was an increased chance of drying of the eye, along with the problems involved with dry eyes. The other procedure, stitching the gland inside some tissue, increased the chance of the fluid building up and forming into a cyst. The authors decided a new, better surgical procedure was required.

While the older procedures were less complicated, this new procedure was an improved way to bring the gland back into it's original place. It involved the suture going through the third eyelid from the top, then the suture was stitched carefully through the gland, and then back through the third eyelid and tied tight, pulling the gland into it's correct place. It was important to make certain that the suture did not stick out from behind the gland and have contact with the eyeball. This procedure was performed on ten dogs, five with a prolapsed gland in one eye, and five with a prolapsed gland in both eyes; therefore there were fifteen procedures altogether.

Of the fifteen procedures, the authors state that all but one of the procedures was successful, with only one dog's gland slipping back out of place. That dog had one of the most difficult cases and when one of his glands, he had both eyes operated on, slipped back, the owners refused a second procedure and dropped out of the study. There was only one strange anomaly which the authors had to deal with; one of the dog's third eyelid's cartilage developed a fold which had to be cut off. As the gland remained in place with seemingly no effects whatsoever, this anomaly was disregarded.

The authors have concluded that their new procedure is an improvement over previous procedures in so much as it neither removes the gland, causing dry-eye problems, nor stuffs it away where it could cause a cyst. They do admit that this new procedure does require more complicated as well as more delicate suturing, but also claim that with proper training, this procedure, once mastered, can be performed in a matter of minutes. They also admit that their study group was small, only ten dogs with only fifteen procedures performed, and do not really have any answer to that.