Removal of the eye, or enucleation, is a surgical intervention, the result of which is the complete removal of the human eyeball. It is prescribed only in cases where it is not possible to save the eye with conventional therapy. At the end of such an operation, the patient should be under the supervision of doctors for a few more days.
Enucleation technology
From the moment the patient is scheduled for surgery, they begin to prepare him for this procedure. If this is a child, he is given general anesthesia, for an adult - local. Then the person is placed on the operating table and the eyeball is opened using a special device - an eyelid dilator. Then, before removing the eye, the surgeon cuts the conjunctiva and cuts it around.
Further, 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 have already been cut off, the doctor pulls out and fastens them with special clothespins. Then the scissors are wound behind the back of the eyeball, they cut off the optic nerve, then surrounding itmuscles. After this, the removal of the eye occurs - 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 within the walls of a medical institution under medical supervision. After some time, he will receive an implant, which is custom-made in accordance with the physiological characteristics of the patient.
The artificial eye is attached to the remaining tendons. Visually, the implant cannot be distinguished from the human eye, which allows a person to feel comfortable and lead a normal life.
Postoperative Therapy
After the removal of the eye of 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 eye drops. There are cases when the implant is able to change its location, which can cause discomfort and discomfort. Such a violation has an unaesthetic appearance. Implant misalignment can only be corrected by a second operation.
Contraindications for surgery
Enucleation, like cataract surgery, has a number of contraindications. The patient should be warned about them before the start of surgery. So, the main contraindication to enucleation is purulent inflammation, which is otherwise calledpanophthalmitis. Since such an inflammatory process can spread to the region of 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 a sharp pain in the blind eye.
- Injuries that destroyed the inner component of the eye.
- An inflammatory process that lasts more than 3 months in the blind eye.
- End-stage glaucoma.
- Herniated eye needed to be removed.
- Removal of the eyeball for cosmetic purposes.
Pain relief before surgery
The eye is removed after the patient has been given an anesthetic. Children are given general anesthesia. In adults - local anesthesia. Half an hour before the operation, the patient receives 1 ml of a 1% morphine solution. Also, adrenaline with novocaine is injected through thin skin into the lower eyelid. In some cases, the doctor performs 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 anesthesia, you must wait 5-7 minutes and you can proceed with the operation. There are cases when novocaine causes an allergy in a patient. Then the doctor replaces this drug with another one.
Complications of enucleation
Reviews about eye removal among patients are different. Most of them lead a normal life and do notfeel discomfort. But there are cases when a person, for one reason or another, has complications after surgery. The most common complications after enucleation are bleeding and inflammation. Doctors are fighting the latter with antibiotic therapy.
However, despite this, the patient after surgery feels relieved and leads a better life than before.
Also, against the background of unsuccessful completion of the operation, the following complications are possible:
- Siderosis is a complication of enucleation that occurs due to the long-term presence of iron compounds in the eye. They can stay there from one week to a year. The very first sign by which siderosis can be determined is the accumulation of siderotic pigment under the lens.
- Chalcosis is the most serious and difficult 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 in 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 several months or even several years after surgery. Copper, in comparison with other substances, slowly decomposes and splits inside the eye, which significantly slows down the development of this complication. Chalcosis is also characterized by clouding of the iris and itsgreenish coloration. In addition to the above characteristics, this complication is accompanied by the greatest accumulation of copper compounds in the anterior chamber. Chalcosis in the future often develops into diseases of the visual apparatus. Among them are glaucoma, cataracts, sometimes the complete death of living muscles and nerves nearby. Sometimes there may be 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).
