Introduction:

Evisceration is a surgical procedure performed to remove the contents of the eye while preserving the sclera and extraocular muscles. This procedure is considered when the eye has become non-functional due to severe trauma, infection, or other conditions, and where conventional treatments are not viable options.

Indications:

Evisceration is indicated in the following cases:

• End-Stage Ocular Disease: When the eye has irreversibly lost its visual function and has severe pain or discomfort.
• Intractable Infections: In cases where ocular infections are unresponsive to medical treatment and pose a risk of spreading to other structures.
• Traumatic Eye Injuries: Severe eye injuries that cannot be salvaged through other surgical interventions.

Procedure:

The evisceration procedure typically involves the following steps:

• Anesthesia: General or local anesthesia is administered to ensure the patient's comfort during the procedure.
• Incision: A circular incision is made in the conjunctiva and the cornea to access the eye's contents.
• Removal of Intraocular Contents: The intraocular contents, including the lens, vitreous gel, and retina, are gently removed.
• Scleral Shell Preservation: The outer scleral shell, which provides structural support to the eye, is carefully preserved.
• Implant Placement: A biocompatible orbital implant is then inserted into the scleral shell to maintain the eye's volume and shape.
• Closure: The conjunctiva and cornea are sutured to secure the implant and promote proper healing.

Postoperative Care:

After the evisceration procedure, patients require meticulous postoperative care, including:

• Eye Patching: An eye patch is placed to protect the surgical site and promote healing.
• Medications: Antibiotics and anti-inflammatory medications may be prescribed to prevent infection and reduce inflammation.
• Follow-Up: Regular follow-up visits with the ophthalmologist are crucial to monitor healing and ensure proper recovery.

Cosmetic Rehabilitation:

Following evisceration, patients have the option of undergoing a prosthetic eye fitting to restore the appearance of the affected eye. Custom-made ocular prostheses are designed to closely match the natural eye, providing an aesthetically pleasing result.

Complications:

While evisceration is generally safe, some complications may arise, including:

• Infection: Infection at the surgical site may occur.
• Implant Exposure: Rarely, the implant may become exposed, requiring corrective surgery.
• Diplopia: Double vision may occur if the extraocular muscles are not properly aligned.

Conclusion:

Evisceration is a surgical option for patients with end-stage ocular disease, severe trauma, or intractable infections. While it is considered a last resort, it can significantly improve the patient's quality of life by alleviating pain and discomfort. Proper postoperative care and cosmetic rehabilitation play a vital role in the overall success of the procedure.

Hashtags: #Evisceration #OcularSurgery #EyeHealth #OcularProsthesis #EyeTrauma #IntraocularContents