Complications Following Nictitating Membrane Resection in Horses: 92 Eyes (2015-2024).

Chronic mild epiphora is the most common long-term complication after equine nictitating membrane resection and requires thorough owner counseling.

This retrospective study evaluated complications following nictitating membrane (NM) resection in 83 horses (92 eyes) over a nearly 10-year period (2015–2024). Inclusion required a minimum of 1 month of postoperative follow-up. Data were collected from medical records and supplemented by owner-reported outcomes via telephone or email questionnaire. The overall owner-reported complication rate was 28.2% (26/92 eyes). Early complications (within 1 week) included fat prolapse (4.3%) and hemorrhage (1.1%). Long-term owner-reported complications included epiphora (22.8%) and conjunctivitis (9.8%). Among the 39 horses that had follow-up examinations, the clinician-identified complication rate was 23.1%, encompassing epiphora (10.3%), fat prolapse (5.1%), enophthalmos (5.1%), and conjunctival adhesion (2.6%). Notably, fat prolapse incidence was low overall and no cases were reported in eyes where sutures were placed, though this finding did not reach statistical significance (p = 0.80). All identified complications were characterized as minor and manageable. Chronic mild epiphora emerged as the most prevalent long-term complication. The authors recommend that clinicians counsel owners preoperatively regarding the likelihood of persistent, low-grade epiphora following NM resection. This study provides useful baseline risk data to guide informed consent discussions and surgical decision-making for this commonly performed equine ophthalmic procedure, though its retrospective design and reliance on owner-reported outcomes introduce potential limitations including recall bias.

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