The Novel Use of a Sub-palpebral Lavage Line As an Indwelling Stent to Manage Unilateral Nasolacrimal Duct Obstruction in a Cat

Objective: To describe a novel surgical approach to conjunctivorhinostomy for feline nasolacrimal duct obstruction.

Animal Studied: A client-owned 4-year-old female spayed domestic shorthair cat presented with chronic unilateral nasolacrimal duct obstruction of the right eye.

Methods: Following obstruction confirmation via complete ophthalmic examination and dacryocystorhinography, conjunctivorhinostomy was performed under general anesthesia, and an indwelling sub-palpebral lavage (SPL) line was placed to facilitate the formation of a new pathway for tear drainage. Specifically, the SPL footplate was sutured to the ventral conjunctival fornix with 5-0 nylon and 6-0 vicryl while the tubing was passed through the new pathway and the distal end of the tubing trimmed and tucked into a perinasal subcutaneous pocket. Two skin sutures closed the perinasal pocket and were removed 2 weeks postoperatively.

Results: No immediate postoperative complications occurred. At 6 weeks and 6 months postoperatively, the distal SPL tubing was dislodged and visible out of the right nostril. This was uneventfully trimmed shorter, and no further complications occurred. The SPL component was easily removed 11 months postoperatively without complication. The patient's clinical signs dramatically improved; she was comfortable over 2 years after surgery.

Conclusion: To the authors' knowledge, this is the first report of using an SPL as an indwelling catheter for nasolacrimal duct surgery via conjunctivorhinostomy in a cat. This technique eliminated external stent sites for the patient, which was associated with a short use of an e-collar, and utilized materials readily available in a specialty hospital.