Информации за тековно работење во услови на Ковид - 19

Повеќе

During enucleation, surgeons try to leave intact the extraocular muscles and the remaining orbital contents.

Although enucleation results in loss of visual function, the procedure is performed to improve the patient’s quality of life.

Description

Enucleation is an operation in which the eye is removed. The eyelids, eyelashes, eyebrows and surrounding skin will remain as they are.

Enucleation is an operation that is used as a last resort, that is, for patients in whom the eye is more of a health risk in the case of pain in the blind or severely injured eye, to alleviate the growth of an eye tumor or persistent infections.

Enucleation is done in children and adults.

Evisceration, as opposed to enucleation, is a procedure in which the contents of the eye are removed without removing the sclera and eye muscles. During surgery, an implant is inserted into the opening to maintain the volume of the orbit and the eye muscles to function.

The purpose of the implant is to allow the opening to heal after which a prosthetic eye or artificial eye can be used.

Indications

In the following cases, enucleation can be applied:

  • Intraocular malignancy or strong suspicion of intraocular malignancy (most commonly uveal melanoma and retinoblastoma)
  • Eye trauma/injury leading to blindness
  • Blind, sore eye
  • A severe infection that led to blindness
  • Sympathetic ophthalmia
  • Microphthalmos

Evisceration is used in cases where removal of the eyeball by enucleation can be avoided.

In the following cases, evisceration can be applied:

  • Endophthalmitis
  • Ocular trauma
  • Blind and sore eye

A detailed evaluation must be done to ensure that there is no intraocular malignant tumor in the eye to be operated on. If it cannot be determined with certainty that there is no such risk, enucleation is applied.

Examination

A detailed subspecialty examination is performed that looks at all segments of the eye. An ultrasound of the eye is performed in order to determine the course of intraocular tumor masses, blood, pus or other fluid inside the eye.

After the examination, if we suspect a tumor, it is recommended to do an MRI of the head and orbits, and additional diagnostics in order to rule out metastatic processes in the body.

Предоперативна подготовка

Preoperative preparation takes about 20 minutes. Patients with chronic diseases, depending on the therapy they are receiving, have special preparations that they are informed about on the day of the surgery appointment.

The preparation is started by the nurse, and then the patient is transferred to the preoperative block and his history is taken. Blood pressure and sugar are checked.

This operation is performed under general anesthesia, which is why an anesthesiological examination is performed beforehand.

After the patient is fully prepared, he is brought into the operating room.

Course of surgery

Enucleation of the eye is done in the operating room, usually under general anesthesia, but in certain cases, local anesthesia can be used.

The surgeon removes the eyeball using one of three main surgical enucleation techniques. An orbital implant is then placed deep into the eye socket, during which the extraocular eye muscles are sutured to the orbital implant. A large pressure bandage is then placed over the eye to prevent bleeding, protect the wound and reduce inflammation.

After healing, a scaly prosthesis is implanted which is designed according to the other eye so that they look the same.

The enucleation takes about an hour to an hour and a half.

Postoperative care

After the surgery is over, the patient is brought into the suite. About half an hour to an hour after the operation, the patient goes home with a bandage covering the eye, which is necessary to keep it dry.

The next day is the first follow up after the surgery, while the next is in 7 days and after a month.

The patient is prescribed therapy and is obliged to use it according to the time period specified by the ophthalmologist. It is also explained to the patient how to clean the eye at home.

Precautions

Restrictions after enucleation are always according to the surgeon’s recommendation.

No physical activity is recommended for two to four weeks after the procedure. It is especially important to use the prescribed therapy regularly and correctly.

It is not unusual to deal with bleeding and bruising around the eye socket due to the surrounding bony structures. There is usually not much pain or discomfort, and these problems usually resolve after a few days.

The medical staff is available 24/7 for any consultation needed after the intervention.

Price

The package includes: surgery with local anesthesia, preoperative preparation and three follow ups.

Anesthesiology examination and general anesthesia are charged additionally.

It is possible to pay in installments without interest and additional costs.

You can check more about the payment method on the current price list of Sistina Ophthalmology.

Subspecialist examination

Refraction, visual acuity measurement, eye pressure measurement, evaluation of posterior segment – examination of anterior and posterior segment.

1.900,00

Echography

1.500,00

Enucleation

Price for one eye.

54.000,00