A 4-year-old Arabian cross paint mare was referred for evaluation of chronic mucopurulent discharge and epiphora of the left eye. Ophthalmic and radiographic evaluations confirmed distal nasolacrimal duct atresia with absence of the nasolacrimal orifice. Initial minimally invasive treatments, including guidewire-assisted catheterization and diode laser photoablation, were unsuccessful. Definitive treatment was achieved using a Fogarty arterial embolectomy catheter under standing sedation. Controlled balloon inflation and deflation enabled progressive dilation of the obstructed duct, and a surgical mucosal opening over the balloon permitted creation of a nasal orifice. A temporary stent was maintained for 4 wk, resulting in successful restoration of nasolacrimal drainage without recurrence of epiphora. Twelve months after catheter removal, no recurrence of ocular discharge was noted. This case report highlights a minimally invasive, effective technique for treating distal nasolacrimal duct atresia in horses when other neocanalization methods are unsuccessful. Key clinical message: A Fogarty catheter-assisted neocanalization offered a practical and effective option for restoring nasolacrimal duct patency in a horse with distal duct atresia and absence of the nasal orifice, providing a minimally invasive alternative when conventional methods failed.
Bourassi et al. (Mon,) studied this question.