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Dog Cherry Eye Surgery Complications

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Dog Cherry Eye Surgery

After getting your dog's cherry eye fixed, the last thing you want to deal with is dog cherry eye surgery complications. After surgery, right when the dog is expected to recover, in some cases dogs may develop a variety of complications such as ocular pain, discharge and redness or even a re-occurrence of the prolapse. As with many other types of surgery, there are several things with dog cherry surgery that may go wrong, but fortunately, in most cases, these complications are temporary or the veterinarian can remedy them.

Cherry eye in dog picture.

Cherry eye in dog picture.

Dog Cherry Eye Surgery 

In order to better understand complications after cherry eye surgery, it helps gaining a better appreciation of what happens when a dog develops cherry eye and undergoes cherry eye surgery.

Cherry eye is nothing more than a prolapsed tear gland of the third eyelid. This gland is known for producing about 30 to 40 percent of a dog's tears.

In a dog with no problems, the gland stays in its proper position which is tucked nicely at the inner corner of the eye, courtesy of a small ligament. When the gland pops out of its normal position, it's because of some level of laxity (looseness) or weakness of the ligament which causes the gland to start protruding as a reddish mass at the corner of the dog's eye, hence the term "cherry eye."

Surgery in most cases consists of re-positioning the gland back into its place. There are several different surgical approaches to accomplish this. Some procedures may be more likely to cause complications than others, and to minimize the chances for such complications, it is best having the surgery performed by a board-certified veterinary ophthalmologist. However, sometimes complications can also be seen for several reasons other than from directly the surgical procedure.

The Eye Getting Rubbed

dog e collar

One complication often seen after surgery derives from the behavior of the dog. After surgery, the surgical site may feel uncomfortable to the dog and the dog may try to find relief by rubbing the eye. It is paramount to prevent this from happening.

It is the dog owner's responsibility to prevent the dog from rubbing the operated eye with the paws or against furniture following surgery at least until the eye heals.

The best way to prevent the dog from rubbing the eye is by letting the dog wear an Elizabethan collar. The collar may need to be worn for seven to fourteen days. Failure to protect the eye can lead to the dog injuring the surgical site.

Onset of Inflammation 

As with any surgery, its quite normal for some inflammation and swelling to set in. Many vets may prescribe corticosteroid eye drops to reduce the inflammation and swelling, but veterinary ophthalmologist Dr. Amy J. Rankin points out that this practice may delay healing of the incision site. Instead, she suggests using a broad-spectrum antibiotic eye ointments such as. neomycin, polymyxin B, and bacitracin and an oral nonsteroidal anti-inflammatory medication for a few days.

If you notice your dog's eye is cloudy and there's discharge, and your dog is squinting, and pawing at the eye, consult with your vet. There may be chances your dog has developed a corneal scratch. If your dog is on steroid eye drops this can make it much worse and get in the way of healing.

"Swelling and redness is common for several days after a cherry eye surgery." ~Dr. Dave, veterinarian.

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Problems with Stitches 

Sometimes a possible complication is the presence of suture rubbing on the inside of the dog's lower eye lid. This may cause the tissue to get very irritated and inflamed. If that's the case, then that suture may need to be clipped, explains veterinarian Dr. Gabby. 

To prevent the stitches from causing problems vets normally take several precautions. First off, they use stitches that are very small and almost hair-like. When the stitches are placed, they should be buried under the incision so that they are prevented from rubbing on the eye, explains veterinarian Dr. Z. 

However, at times, there is no way to really predict what till happen and how a dog may react to the stitches. For instance, the stitch may un-tie or sometimes dogs develop allergies to the stitches and this is something that cannot be predicted. If there is a suture reaction, a second surgery may be needed to remove the stitches.

Onset of Dry Eye

Vet checks a dog's eye

Vet checks a dog's eye

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One of the most likely complications of cherry eye surgery (though likely to set in later in life) is the onset of a medical condition known as keratoconjunctivitis sicca. This is just a fancy name for dry eye.

This complication is mostly seen in dogs that have had their gland surgically removed considering that this gland is responsible for producing tears.

While a dry eye may not seem like a big deal, it is very uncomfortable to the dog and it requires lifelong use of eye drops several times a day to keep the eye lubricated.

It is therefore a preferable to handle a case of cherry by tacking the gland back into position, back where it belongs.. The gland can be tacked to dog's periorbital tissue or the orbital rim.

Another common dog cherry eye surgical procedure is the "pocket technique" also known as the pouch technique or imbrication technique where a pocket of tissue is made by making a little incision in front and behind the gland, the gland is tucked inside the pocket and then the pocket is stitched closed. A modified pocket technique known as "the Morgan pocket technique" offers several advantages.

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With tacking, the function of the tear gland is preserved. While this tacking procedure may be more costly than removing the gland, in the long run, the costs are less than treating a chronic dry eye with repeated need for consultations and medications, explains veterinary ophthalmologist Dr. Michael Zigler.

"It is important not to excise or partially amputate the prolapsed gland because this may predispose the dog to the development of keratoconjunctivitis sicca later in life."~Dr. Amy J. Rankin, veterinary ophthalmologist.

Did you know? In the past the important role of the third eyelid's gland tear production was unknown. The lump in the corner in the eye was treated like a tumor and was always surgically removed. Fortunately nowadays we know better!

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Re-occurrence of Cherry Eye 

dog gallbladder removal surgery

Repeated surgeries for cherry eye in dogs are not unheard of.

Unfortunately, in some cases, cherry eye may come back and dog owners feel frustrated because they are back to square one. Statistically, it has been found that the recurrence rate for cherry eye surgery is around 10 to 20 percent meaning that surgery will have to be repeated.

Generally, re-occurrence of cherry eye in dogs tends to happen shortly after surgery and it's most likely seen in older dogs when the prolapsed gland is huge and has a history of being chronically inflamed, points out veterinarian Dr. Gabby. Certain dog breeds are more prone to re-occurrence than others.

While tucking the gland back to where it belongs is the preferred option to prevent dry eye, it is also true that this surgical approach can lead to failure, possibly requiring a second or even third tuck. In this case, what happens is that the tuck fails to be anchored enough to hold the gland in position permanently, explains veterinarian Dr. Wendy C. Brooks. 

If there are relapses, perhaps it's time to consider another surgical approach such as the imbrication technique, as described above. As mentioned, this type of repair is best done by a board-certified ophthalmologist.

"Unfortunately, no surgical procedure is 100% effective, and occasionally additional surgery is needed." ~American College of Veterinary Ophthalmologists

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References:

  • Veterinary Partner: Cherry Eye
  • Zigler Veterinary Professional CorporatiomProlapsed Gland of the Third Eyelid
  • DVM360: Skills Laboratory: Prolapsed third eyelid gland replacement

Photo Credits:

  • Close-up of a cherry eye Joel Mills - Own work Prolapsed gland of the third eyelid (cherry eye) in a dog. CC BY-SA 3.0

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