Lapis ISSN 2398-2969

Enucleation: transconjunctival

Contributor(s): David L Williams, Livia Benato, David Gould, Vetstream Ltd, Vladimir Jekl

Introduction

  • Enucleation is required for a globe with a painful condition such as uncontrolled uveitis   Eye: uveitis  and also in some rabbits with a retrobulbar abscess Eye: retrobulbar abscess.
  • Transconjunctival (subconjunctival) approach refers to the surgical technique where the globe, nictitating membrane and lid margins are excised while leaving as much soft tissue as possible to minimize the orbital depression.

Uses

  • Medical conditions such as uncontrolled uveitis, endophthalmitis, uncontrolled glaucoma, severe exophthalmos, chronic keratitis, perforated cornea, globe perforation, globe damage or trauma, intraocular and retrobulbar neoplasia, retrobulbar abscess.

Advantages

  • Removes painful or damaged eye.
  • Using this technique, the fat and extraocular muscles are retained, improving the cosmetic results.
  • Considered less traumatic with less hemorrhage and better exposure of optic nerve and orbital vessels.

Disadvantages

  • Loss of sight.
  • May not cure orbital abscessation.
  • Bacteria present in the conjunctival sac may be introduced into the orbit.
  • More tissue will be left behind, and in case of neoplasia there are more chances of leaving neoplastic tissue within the globe.

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

  • Generally good prognosis.
  • Guarded if retrobulbar abscess.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Myrna K E, Bentley E & Smith L J (2010) Effectiveness of injection of local anesthetic into the retrobulbar space for postoperative analgesia following eye enucleation in dogs. JAVMA 237 (2), 174-177 PubMed.
  • Mitchell N (2008) Enucleation in companion animals. Irish Vet J 61 (2), 108-114 VetMedResource.
  • Holmberg B J (2007) Enucleation of exotic pets. J Exotic Pet Med 16 (2), 88-94 VetMedResource.
  • Kern T J (1997) Rabbit and rodent ophthalmology. Semin Avian Exotic Pet Med (3), 138-145 ScienceDirect.

Other sources of information

  • Fehr M (2013) Eye and Eyelid Surgery. In: BSAVA Manual of Rabbit Imaging, Surgery and Dentistry. Eds: Harcourt-Brown F M & Chitty J. BSAVA, UK. pp 233-253.
  • Spiess B M (2007) Diseases and Surgery of the Canine Orbit. In: Veterinary Ophthalmology. 4th edn. Ed: Gelatt K N. Blackwell Publishing, UK. pp 539-562.
  • Redrobe S (2006) Surgical Procedures and Dental Disorders. In: Manual of Rabbit Medicine and Surgery. Ed: Flecknell P. BSAVA, UK. pp 117-134.


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