Marsupialization of a cyst of the nictitating membrane in three dogs

Background Development of cysts has been reported as a potential complication after surgical repositioning of nictitating membrane gland protrusion using the conjunctival pocket technique. To the authors' knowledge, no treatment for these cysts has ever been published. Objectives This short case series describes a surgical technique of marsupialization as a treatment option for these cysts and proposes a pathogenesis for cyst formation. Cases description Three dogs were each referred for a unilateral subconjunctival mass-like lesion involving the bulbar side of the nictitating membrane. Complete ophthalmologic examination revealed a pink, translucent, soft, and nonpainful mass protruding from the bulbar surface of the nictitating membrane in all cases. Treatment consisted in marsupialization of the cyst on the palpebral surface of the nictitating membrane and was curative with no short-term postoperative complication and favorable long-term outcome for the three dogs. Histopathological findings were consistent with a lacrimal cyst. Conclusion Marsupialization appears to be a safe, simple, and effective treatment for nictitating membrane cyst secondary to surgical correction of gland prolapse using conjunctival pocket technique in dogs. Further studies on a larger number of cases are necessary to determine whether marsupialization is the technique of choice and to further investigate the pathophysiology of cyst formation after conjunctival pocket repositioning of prolapsed glands.