Eye removal, or enucleation, is a surgical procedure that results in the complete removal of a person’s eyeball . It is prescribed only in cases where conventional therapy fails to save the eye. At the end of such an operation, the patient should be under medical supervision for several more days.
Technology of the enucleation procedure
From the moment the patient is prescribed surgery, they begin to prepare him for this procedure. If this is a child, he is given general anesthesia, an adult - local. Then the person is placed on the operating table and the eyeball is opened with the help of a special device - an eyelid expander. Then, before removing the eye, the surgeon dissects the conjunctiva and cuts it off in a circle.
Next, with a special hook-shaped device, the eye socket is hooked and the rectus muscles are cut off. At this time, the oblique muscles remain intact. The muscles that are already cut off, the doctor pulls out and fastens them with special clothespins. Then the scissors wind up behind the back of the eyeball, they cut off the optic nerve, then the muscles surrounding it. After this, the eye is removed - enucleation. In cases of bleeding, it is stopped with hydrogen peroxide and a specially prepared swab.
Next steps
After the operation, the patient must be in the walls of a medical institution under the supervision of physicians. After some time, he will have an implant installed, which is specially made to order in accordance with the physiological characteristics of the patient.
The artificial eye is attached to the remaining tendons. Visually, an implant cannot be distinguished from the human eye, which allows a person to feel comfortable and lead a familiar lifestyle.
Postoperative Therapy
Upon completion of the removal of the eye in a person, he is prescribed a course of rehabilitation therapy in order to prevent the development of inflammatory processes. Also, the patient should use topical ointments or drops for the eyes. There are times when the implant is able to change its location, which can cause discomfort and discomfort. Such a violation has an unaesthetic appearance. Correction of the implant displacement is possible only by repeated operation.
Contraindications for surgery
Enucleation, like cataract surgery, has a number of contraindications. About them, the patient should be warned before surgery. So, the main contraindication for enucleation is purulent inflammation, which is also called panophthalmitis. Since such an inflammatory process can spread to the orbit, and then to the brain. Enucleation is also contraindicated in case of general infection of the body.
Indications for enucleation
The main indications for enucleation are:
- The appearance of sharp pain in the blind eye.
- Injuries that destroy the inside of the eye.
- An inflammatory process that lasts more than 3 months in the blind eye.
- Glaucoma, which is in a terminal stage.
- Need to remove a hernia of the eye.
- Removal of the eyeball for cosmetic purposes.
Anesthesia before surgery
Eye removal occurs after the patient has been given an anesthetic. In children - general anesthesia. In adults, local anesthesia. Half an hour before surgery, the patient receives 1 ml of 1% morphine solution. Adrenaline with novocaine is also injected through the thin skin into the lower eyelid. In some cases, the doctor conducts anesthesia of the conjunctival membrane. At the same time, he injects novocaine with adrenaline near the cornea (under the conjunctiva).
After the patient has received a dose of analgesia, it is necessary to wait 5-7 minutes and you can proceed with the operation. There are times when novocaine causes an allergy in the patient. Then the doctor replaces this drug with another.
Enucleation Complications
Reviews about eye removal among patients are different. Most of them lead a familiar lifestyle and do not feel discomfort. But there are times when a person for one reason or another has complications after surgery. The most common complications after enucleation are the opening of bleeding and inflammatory processes. Doctors fight the latter with antibacterial therapy.
However, despite this, the patient after the surgery feels relief and leads a better life than before.
Also, against the background of an unsuccessful completion of the operation, such complications are possible:
- Siderosis is a complication of enucleation that occurs due to the prolonged presence of iron compounds in the eye. They can be there from one week to a year. The very first sign by which siderosis can be identified is the accumulation of siderosic pigment under the lens.
- Chalcosis is the most serious and complex complication of enucleation. Chalcosis is characterized by the presence of copper compounds in the eye. It, unlike iron, causes not only atrophic processes, but also contributes to significant inflammatory processes of the eyeball. This complication is also accompanied by the dissolution of copper in the eye tissues, which eventually develops into purulent processes. Often, the first signs of chalcosis may appear after several months or even several years after surgery. Compared with other substances, copper slowly decomposes and breaks down inside the eye, which significantly slows down the development of this complication. Chalcosis is also characterized by clouding of the iris and its color in a greenish tint. In addition to the above characteristics, this complication is accompanied by the largest accumulation of copper compounds in the anterior chamber. Chalcosis in the future often develops into diseases of the visual apparatus. Among them are glaucoma, cataract, sometimes the complete death of living muscles and nerves that are nearby. Sometimes the appearance of blindness of the second eye, a decrease in the boundaries of vision and the appearance of scotomas (small areas of the visual field where there is absolutely no light) are possible.