Written Exam - Enucleation Flashcards
what is the difference between enucleation & exenteration?
enucleation - removal of the globe
exenteration - removal of the globe & orbital contents
what are the 2 methods used for enucleation?
transpalpebral - initial cut around eyelid margins
transconjunctival - initial cut around conjunctiva
when can you not use a transconjunctival method for enucleation?
if the eye is infected
what must you identify to avoid post-op complications in a transconjunctival enucleation?
all conjunctiva & 3rd eyelid
T/F: a transpalpebral approach for enucleation can be used in all situations
true
why is blindness in the remaining eye a problem seen after enucleation?
excessive traction applied on the optic nerve damages the optic chiasm
what is the more versatile method for enucleation that has fewer complications?
transpalpebral
how should a patient be prepped & positioned for an enucleation?
fur is clipped to midline - dilute 1% betadine solution, clear conjunctival fornixes with cotton tip applicators
dorsal recumbency with palpebral fissure parallel to the floor
how can you assist in hemostasis in an enucleation?
pack the orbit with gauze & apply pressure for 5 minutes - if major bleeding, repeat packing, clamp/tie off/cautery
what is the holding layer for an enucleation?
periorbital fascia - firm tissue associated with bony orbital rim
what is the goal of the 1st layer of closure in an enucleation?
complete closure across the orbit - helps decrease swelling, tamponades orbital bleeding post-op, & helps prevent sunken appearance
what does post-op care look like in an enucleation patient?
ice pack until animal wakes up or resists, perioperative antibiotics, analgesics (3-5 days), & e-collar
when are orbital prosthetics contraindicated?
cases of infection & neoplasia
what is a common appearance of an enucleation patient 24 hours post-op?
bruising & a small amount of bleeding
what are the most common intraoperative mistakes made in enucleations?
- removing too much eyelid skin - difficult closure & poor aesthetic look
- failing to identify & remove all conjunctiva/eyelid margin - orbital cyst!!
- failure to identify & transect the extraocular muscles - more bleeding during surgery
- blinding the contralateral eye - especially in cats
what condition is seen in this post-op enucleation case? why did it occur?
orbital cyst
failure to identify & remove all conjunctiva, lid margin, or 3rd eyelid gland
what long-term complication from an enucleation is seen here?
orbital pneumatosis
