Oct 31, 2015
Enucleation of eye ball
The Removal of the globe
Enucleation : the removal of the globe and nictitating membrane.
Exenteration : removal of the globe, nictitating membrane, orbital contents and lid margins.
WHY MIGHT THIS PROCEDURE COME TO BE NECESSARY?
It has no chance of being capable of sight and it is painful.
Trauma to the eye - scratch to the eye that becomes infected - hitting the eye on something sharp
Tumors of the eye
Glaucoma
Endophthalmitis, panophthalmitis
Herpes infection related ulcers on the eye (in cats) are all catastrophes to the eye.
Others create a painful blinded eye.
Brachycephalic breeds
cataract ulcer
glaucoma trauma Cornea erosion
Orbital anatomy
Medial wall frontal, maxillary, lacrimal, zygomatic bones
Caudomedial wall presphenoid, basisphenoid, palatine bones
Anatomy
Dog medial and dorsomedial wall of the orbit
Cat entirely bone ; zygomatic process, frontal process come into proximally
Anatomy
Anatomy
Enucleation
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Patients signalmentsName : Species : canineBreed : schnauzerSex : FemaleAge : about 1 yr Weight : 5 kgB.T : 38.0 R.R : 40 / minPurse : 130 / min
CBC & Serum chemistry
RBC 725 * 104 /ul 540 ~780 x 104
WBC 16.5 * 103 /ul 6~17 x 103
PCV 35 % 37~54Fibrin 200 mg/dl 100~400Total Protein 7.8 g/dl 6.0~7.8BUN 11.5 mg/dl 10~25Creatinine 0.7 mg/dlAST 53.5 U/L
Preoperative treatment
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Preoperative treatment - Anesthesia
1 ( GPS 0.1ml/kg I.M )
15~20 Atropine Sulfate 0.04 mg/kg, S.C. Zoletil50 7 mg/Kg, I.V.
Procedure
Ventral recumbency
Draping ocular surgery
Eye wash 2~10% povidone - iodine in saline
Procedure
Procedure
Procedure
Suture
- conjunctiva, Tenons capsule, orbital septum : simple interrupted sutures of 4-0 absorbable
- subcutaneous layer : simple continuous sutures of 4-0 absorbable
- Skin : simple interrupted of 4-0 nonabsorbable
Procedure
After surgery
Orbital prosthesis
Implantation of silicone prosthesis after enucleation or exenteration reduces the facial distortion
Post operative care
Elizabethan collar
WHAT SIGNS WOULD INDICATE A PROBLEM?Infection Remaining swollen after the initial week the incision may drain pus If this occurs, the infection would require drainage and antibiotics.
If the eye was enucleated due to a severe tear or rupture, the eye may not be removed in one piece.
Sometimes a small fragment of the rear eye membranes remains behind. If enough of this tissue is present, secretion of fluid can continue and chronic oozing from the incision can be a problem. If this is excessive, the eye socket may require a second surgery to be fully cleaned out. Both these complications are very rare.
References
Small animal surgery, Mosby, Cheryl S.Hedlund
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