Fast, Simple, and Successful: A Minimally Invasive Fix for Canine Dacryocystitis

A transconjunctival surgical technique for dacryocystotomy in dogs with foreign body‐induced dacryocystitis

Ingrid Allgoewer, Petr Soukup, Eberhard Ludewig

Background
Foreign body-induced dacryocystitis in dogs leads to mucopurulent ocular discharge and nasolacrimal duct obstruction, often unresponsive to medical management. Traditional surgical approaches are invasive, involving transosseous access or canalicular incisions. This study introduces and evaluates a minimally invasive transconjunctival dacryocystotomy technique that permits full inspection of the lacrimal sac while avoiding bone disruption or permanent canalicular damage.

Methods
This retrospective study included 48 dogs treated from 2003 to 2023 with presumed foreign body-induced dacryocystitis who underwent surgical exploration via the transconjunctival approach. The technique involved conjunctival incision and blunt dissection to expose the lacrimal sac, allowing foreign body removal. An indwelling catheter was placed in most cases postoperatively. Outcome measures included nasolacrimal duct patency, catheter retention time, and postoperative complications, with a median follow-up of 34 days.

Results
Foreign bodies (mostly grass awns) were identified in 85% (41/48) of cases, typically lodged just proximal to the lacrimal foramen. Indwelling catheters were successfully placed in 83% of dogs for a median duration of 21 days. The nasolacrimal duct was patent at last recheck in 87% of cases (41/47). Minor complications included self-removal of the catheter in two dogs and irritation in one. Clinical resolution of dacryocystitis was achieved in all cases with long-term follow-up.

Limitations
Advanced imaging was not employed, relying solely on clinical signs for diagnosis. Not all cases had bacterial culture or histopathologic confirmation. The lack of long-term follow-up in some dogs and variability in catheter use may have affected assessment of persistent duct patency.

Conclusions
The transconjunctival approach to dacryocystotomy is a safe, quick, and effective surgical technique for managing foreign body-induced dacryocystitis in dogs. It minimizes trauma and preserves nasolacrimal function, with high success in reestablishing duct patency and resolving clinical signs. It represents a practical alternative to more invasive methods and warrants broader clinical adoption.

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