ISSN 2398-2993      

Enucleation

obovis
Contributor(s):

Ash Phipps

John Tulloch

University of Liverpool logo

Synonym(s): eye: surgical removal


Introduction

  • The enucleation procedure involves the surgical removal of the globe.
  • It involves the transection of the six extraocular muscles and the optic nerve (minimal amounts of extraocular muscle and periorbital tissues are removed).
  • The most common approach used in bovines is the transpalpebral technique.
  • An exenteration procedure involves the surgical removal of the globe and all periocular tissue down to the level of the bone.  Again the most common approach used in bovines is the transpalpebral technique.
    • Note: the exenteration technique is more commonly used for cases of severe diffuse ocular and perioccular squamous cell carcinomas (SCC). 

Uses

  • Indications for enucleation/ exenteration include the following: 
    • Extensive inflammation (panophthalmitis) or trauma to the orbit or periorbital tissues (abscessation).
    • Severe exophthalomos resulting in exposure keratitis.
    • Severe perforating ulceration.
    • Glaucoma. 
    • Extensive ocular and periocular neoplasms- commonly SCC, lyphosarcomas.
    • Severe Infectious bovine keratoconjunctivitis (IBK) Infectious bovine keratoconjunctivitis that has resulted in globe rupture.
    • Congenital defects.

Advantages

  • Relatively straight-forward technique to carry out.
  • Successful surgery results in the animal remaining in the herd.

Disadvantages

  • Severe pyogenic infection or diffuse neoplasia can make the procedure more technically difficult.
  • Entire diseased tissue may not be removed, ie neoplasm.
  • Orbital infection may cause wound breakdown (and rejection of prosthesis, in the unlikely event of a prosthesis being used in cattle!).
  • Transpalpebral technique is associated with an increased risk of hemorrhage.
  • Severe swelling post-surgery is often observed.
    • Note: ensure a discussion about the short-term aesthetics (gross swelling of the orbital cavity) and long-term aesthetics (chronic appearance of a concavity of ocular recess), of the procedure, is had with the client.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Good - Low incidence of complications.

Further Reading

Publications

Refereed papers

Other sources of information

  • Anderson D E & Rings M (2008) Current Veterinary Therapy: Food Animal Practice. 5th edn. Elsevier Health Sciences.
  • Divers T J & Peek S (2007) Rebhun's Diseases of Dairy Cattle. 2nd edn. Elsevier Health Sciences.
  • Fubini S L & Ducharme N (2004) Farm Animal Surgery. 1st edn. Elsevier Health Sciences.

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