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Results for “Eye Evisceration”

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At least 19 recordsLinked to original sources
PubMed1995

Clinical application of coralline hydroxyapatite ocular implants in the eviscerated eyes.

BACKGROUND: During the past several years, coralline hydroxyapatite ocular implant has gained increasingly wide acceptance among ophthalmologists. This ocular implant is used in eviscerated eyes to restore volume loss. Its advantages and complications are presented. METHODS: Seventy-three patients received a coralline hydroxyapatite sphere as a buried integrated ocular implant after evisceration surgery between August 1991 and May 1994. The follow-up period was from 4 to 33 months, with mean of 13.5 months. RESULTS: There have been no recognizable cases of orbital infection, implant extrusion, or implant migration. Complications have been minimal and easily managed. Motility of the socket and fornices has been excellent, and most patients have cosmetically satisfactory motility of the prosthesis. CONCLUSIONS: The hydroxyapatite implant appears to offer excellent cosmetic reconstruction without the unacceptable infection and extrusion rates seen with other implants.

Adolescent↗
PubMed2006

Comparing outcomes of enucleation and evisceration.

PURPOSE: To compare clinical outcomes of enucleation and evisceration by functional and aesthetic measures. DESIGN: Retrospective, nonrandomized, comparative analysis. PARTICIPANTS: Eighty-four patients who underwent enucleation or evisceration. METHODS: The medical records of the participants were retrospectively reviewed. Clinical photographs were graded by blinded observers for qualitative measures. MAIN OUTCOME MEASURES: Postoperative eyelid and motility measurements, as well as subjective grades of various aesthetic and functional outcomes. RESULTS: There is no statistically significant difference in the overall aesthetic outcome of enucleation and evisceration, although several specific comparisons were found to be significant. Implant motility score is higher in eviscerated eyes (5.58+/-2.08) than in enucleated eyes (4.35+/-1.69) (P = 0.05). Adduction of the implant is significantly less than abduction in eviscerated eyes (1.34 vs. 1.44; P = 0.02). Implant motility is greater than prosthesis motility. Both enucleation and evisceration result in enophthalmos and a sulcus defect. Seven of 32 patients (21.9%) who underwent enucleation experienced a complication, whereas only of 7 of 52 patients (13.5%) who underwent evisceration experienced a complication (P = 0.0002). The 2 most common complications were implant exposure and formation of a pyogenic granuloma. CONCLUSIONS: Although enucleation and evisceration produce aesthetically similar outcomes, eviscerated eyes have better implant motility and experience fewer complications. Both enucleation and evisceration result in enophthalmos, sulcus contour defects, and incomplete transfer of implant motility to the prosthesis.

Blindness↗
PubMed1997

[Endogenous endophthalmitis in severe generalized diseases].

BACKGROUND: In spite of modern antibacterial, antimycotic and operative therapies, endogenous endophthalmitis connected with other severe diseases and an impaired state of health is an eye complication with a very poor prognosis. PATIENTS: The study presents observations about the progress of the endogenous endophthalmitis in five eyes of four patients. The age of the patients ranged from 58 to 71 years. The span between the appearance of the first eye symptoms and hospital treatment amounted to 1 week and 3 months. The general diseases have been diagnosed as endometrium cancer, colon cancer, corpus uteri cancer (with intestinal fistula) and pancreatic insufficiency (with subclavian catheter) as well as diabetes mellitus. RESULTS: In regard to the infections we analyzed (Candida albicans in 3 eyes, bacteria in 2 eyes), very intensive medical treatment was initiated, including antibacterial or antimycotic therapy (local, subconjunctival, intraocular and systemic) as well as pars plana vitrectomy and/or vitreous puncture. Nevertheless, by the end of the clinical attendance, the following statements were established: one-eye enucleation, one-eye evisceration, two eyes perception of light, one eye visual acuity 0.2. CONCLUSION: The patients should be immediately admitted to a hospital with a department for vitreous surgery. Only with this option is it possible to initiate adequate therapy.

Aged↗
PubMed2000

Keratocyte loss in Acanthamoeba keratitis: phagocytosis, necrosis or apoptosis?

PURPOSE: Pathogenesis of Acanthamoeba keratitis involves breakdown of epithelial barrier, stromal invasion by Acanthamoeba, loss of keratocytes, inflammatory response and finally stromal necrosis. The loss of keratocytes, believed to be due to the phagocytic activity of the parasite, occurs disproportionate to and independent of the parasite load, thereby suggesting additional modes of cell loss. To test our hypothesis that the loss of keratocytes in Acanthamoeba keratitis is due to apoptosis, we did both histology and histochemistry on the corneal tissues. METHODS: Routine Haematoxylin and Eosin, Gomori's Methenamine Silver and Periodic acid Schiff stained sections of five corneal tissues from penetrating keratoplasty and eviscerated eyes were reviewed. TUNEL staining was done for morphological detection of apoptosis in three cases, using formalin-fixed, paraffin-processed tissues. RESULTS: Histological changes were epithelial ulceration, loss of keratocytes in all layers, inflammation in anterior two-thirds of the stroma with necrosis, and deeper quiet stroma. Acanthamoeba trophozoites were found in the anterior stroma while the cysts were more in the deeper stroma, with minimal or no inflammatory response. TUNEL staining was positive in keratocytic nuclei in all layers. CONCLUSIONS: This study demonstrates that one of the modes of keratocyte loss in Acanthamoeba keratitis is by apoptosis, possibly in addition to the necrotic process and phagocytic activity of the parasite. The death of inflammatory cells also appears to be mediated by apoptosis.

Acanthamoeba↗
PubMed2003

Comparison of synthetic hydroxyapatite and porous polyethylene implants in eviscerated rabbit eyes.

PURPOSE: Synthetic hydroxyapatite and porous polyethylene (Polipore) spheres were placed in rabbits' eviscerated cavities to evaluate tissue reaction and volume maintenance. METHODS: Fifty-six Norfolk albino rabbits underwent unilateral evisceration and implantation of synthetic hydroxyapatite (H group, 28 animals) or porous polyethylene spheres (P group, 28 animals). Postoperative reactions, animal behavior, and socket conditions were monitored. Light microscopy and morphometric evaluation with statistical analysis of the exenterated orbits were performed at 7, 15, 30, 60, 90, 120, and 180 days. Scanning electron microscopy was appraised 7, 60, and 180 days after surgery. RESULTS: Two animals from the H group and 1 from the P group had extrusion 7 days after surgery. Throughout the experimental period, the synthetic hydroxyapatite caused more inflammation than the porous polyethylene material. Ingrowth in the sphere occurred 7 to 15 days after the surgery in both groups, and the tissue reaction became denser at approximately 60 to 90 days, when bony metaplasia began in the H group. Volume maintenance was better in the P group and with a smaller pseudocapsule surrounding the implanted sphere than in the H group. CONCLUSIONS: Clinical findings demonstrated mild inflammation inside the sphere and in the pseudocapsule surrounding it and better cavity volume maintenance in the P group animals. The authors consider porous polyethylene a more suitable material than synthetic hydroxyapatite for use in anophthalmic cavity reconstruction.

Animals↗
PubMedDate not supplied

Evaluation of a double-setting alpha-tricalcium phosphate cement in eviscerated rabbit eyes.

PURPOSE: To evaluate the macroscopy, microstructure, and tissue reaction of a double-setting alpha-tricalcium phosphate bone cement used as an intraocular implant in rabbits. METHODS: The internal and external surface of the double-setting alpha-tricalcium phosphate implant was analyzed macroscopically and by scanning electron microscopy. Twelve New Zealand rabbits received 12-mm implants made of double-setting alpha-tricalcium phosphate cement after unilateral evisceration. Clinical evaluation was performed daily for the first 15 days after surgery and at 15-day intervals until the end of the study period. For histopathologic analysis, 3 animals per experimental period were submitted to enucleation at 15, 45, 90, and 180 days. RESULTS: On gross inspection, the external surface of the implant was solid, smooth, and compact. The microarchitecture was characterized by the formation of columns of hexagonal crystals with interconnecting channels forming micropores. No wound dehiscence, signs of infection, or implant extrusion were observed in any animal throughout the study period. Histologic examination revealed the formation of fibrovascular tissue surrounding the implants, and there were signs of minimal integration of the surface limiting the fibrocellular cap with the space previously occupied by the implant. CONCLUSIONS: The double-setting alpha-tricalcium phosphate implant behaved as an inert and non-integratable material. The lack of incorporation of this material by fibrovascular tissue is related to its characteristics of compactness and high resistance.

Animals↗
PubMed2006

Unilateral evisceration of an eye following cornea and lens perforation in a sulfur-crested cockatoo (Cacatua galerita).

A 24-year old male sulfur-crested Cockatoo (Cacatua galerita) was presented with a subacute perforation of the cornea without involvement of the lens. The bird was treated conservatively and the eye remained quiescent up to a second traumatic corneal perforation associated with a lens capsule rupture 15 months later. Due to the second perforating trauma of an already blind eye involving the lens, evisceration of the eye was performed. Two months after surgery the cosmetic result was excellent. Treatment options for perforating ocular traumas in captive birds are discussed in detail.

Animals↗
PubMed2001

Migration of intraocular silicone oil into the subconjunctival space and orbit through an Ahmed glaucoma valve.

PURPOSE: To report a patient with intraocular silicone oil migration into the subconjunctival space and orbit through an Ahmed glaucoma valve implant. METHODS: Observational case report. A 29-year-old female with diabetes mellitus and proliferative diabetic retinopathy underwent three left eye pars plana vitrectomies and ultimately intraocular silicone oil placement for tractional retinal detachment. Subsequently, she developed neovascular glaucoma and underwent an inferotemporal Ahmed glaucoma tube implant, left eye. RESULTS: Intraocular silicone oil migrated through the Ahmed glaucoma valve into the subconjunctival space and orbit. Left eye evisceration with silicone oil removal was performed for a blind painful left eye and improvement of appearance. CONCLUSION: Silicone oil migration through an Ahmed valve may be observed after retinal detachment repair with intraocular silicone oil. An Ahmed valve may be contraindicated in eyes of patients with intraocular silicone oil.

Adult↗
PubMed1999

Hypodermic needles: a new source of penetrating ocular trauma in Indian children.

PURPOSE: To study the clinico-microbiologic profile and visual prognosis of ocular injuries caused by disposable hypodermic needles used by children to squirt water. METHODS: We analyzed 19 consecutive cases of hypodermic needle injury seen at our institute. RESULTS: The average age of the patients was 10.3 years (range, 4-20 years). A small self-sealed corneal or scleral laceration was seen in 11 eyes; in 8 eyes, the site of injury was occult. Initial visual acuity was no light perception (3 eyes) or hand motion or light perception (16 eyes). Surgery in 18/19 eyes included vitrectomy with intraocular antibiotic injections for endophthalmitis (14 eyes), evisceration for panophthalmitis (2 eyes), and cataract extraction for traumatic cataract (2 eyes). Final visual acuity was no light perception or light perception only in 10 eyes, 20/400-20/60 in three eyes, and 20/40 or better in six eyes. CONCLUSIONS: Severe ocular morbidity may result from improper disposal of hypodermic needles.

Adolescent↗
PubMed1997

A new type of intraocular prosthesis for dogs.

A simple technique is described in which sterile silicone oil (viscosity 350 cSt) was injected into the globe of an eviscerated eye with an intact cornea and sclera; the volume injected was calculated from the formula 3/4 pi r3 where 'r' was the horizontal corneal diameter. After induction of general anaesthesia and routine preparation of the surgical site, the globe was eviscerated by using a transscleral or transcorneal approach. The procedure was carried out in five dogs with follow-ups ranging between 19 and 27 months. None of the eyes developed postoperative complications. In one dog, more silicone oil had to be injected 10 days after surgery to increase the size of the globe to match the other eye. The intraocular contents were removed more easily by using the transcorneal approach, which also resulted in a perfect adjustment and virtually eliminated the possibility of leakage of silicone oil, than by a transscleral approach. The dogs responded extremely well and their owners were satisfied with the cosmetic appearance of their pets.

Animals↗
PubMed2002

A study of the indications and changing trends of evisceration in north India.

AIM: To study the demographic pattern and indications for evisceration in north India and to evaluate the changing trends over the last decade. METHODS: In a retrospective hospital-based study, case records of all patients who underwent evisceration at Rajendra Prasad Centre for Ophthalmic Sciences from January 1990 to December 1999 were reviewed. The parameters evaluated were the age and sex distribution, the place of residence (urban/rural) and the indications for evisceration. The aetiology responsible for evisceration was determined on the basis of history, clinical examination and investigations as determined from previous records. RESULTS: One hundred and sixty-four patients had one eye eviscerated during the study period. The mean age of the patients was 51 +/- 13.84 years (range 6 months to 90 years). Panophthalmitis was the most common indication for evisceration (78.6%, n = 129), followed by irreparable globe injury (21.3%, n = 35). There was a significant decrease in the eviscerations performed due to pano-phthalmitis from 104 cases during the period 1990-1994, to 25 cases in the period 1995-1999. CONCLUSION: Panophthalmitis and severe ocular injury are the major indications of evisceration in north India. There has been a significant decrease in the number of eviscerations related to panophthalmitis over the last decade.

Adolescent↗
PubMed1987

Evisceration of the eye with expansion sclerotomies.

An evisceration procedure is described that permits the use of a large implant, even when the cornea is removed. A recent study has revealed that there is a significant incidence of implant extrusion after the traditional evisceration operation. This new procedure not only permits the use of larger implants when indicated, but the possibility of implant extrusion is minimized by a secure, tension-free anterior wound closure. This is accomplished by the use of multiple sclerotomies that expand the scleral shell, by use of fixation sutures between implant and shell that additionally reduce tension on the wound closure, and by the imbrication of the anterior scleral flaps to enhance the strength of the closure.

Eye Enucleation↗
PubMed1999

[Peribulbar anesthesia for peroperative and postoperative pain control in eye enucleation or evisceration: 31 cases].

OBJECTIVES: The aim of this prospective study was to assess peroperative and postoperative analgesia in eye enucleation or evisceration performed under peribulbar anesthesia. PATIENTS AND METHODS: We report 31 patients undergoing an eye enucleation (17 cases) or evisceration (14 cases). The surgical procedure was performed under local anesthesia alone in 22 patients. General anesthesia was associated with local anesthesia in 9 patients. Peribulbar block was achieved with the first insertion of the needle parallel to the inferior orbital floor and the second at level of supraorbital notch. A mixed anesthetic solution of equal quantity of lidocaine 2% with epinephrine (0.25 mg/20 ml) and bupivacaine 0.50% with epinephrine (0.10 mg/20 ml) was injected (total quantity 16.8 +/- 4.3 ml). RESULTS: To assess the peroperative pain we considered the patients with local anesthesia only (22 patients). One of these 22 patients needed one injection (0.50 mg/kg) of propofol for cutting the optic nerve. Surgery was ended without any other drug but that case was considered as a failure. Peroperative analgesia was obtained in 21 of 22 patients (95.4%). To assess analgesia in the postoperative period we included 31 patients. Analgesia was complete from the accomplishment of the peribulbar block to the 4th hour in all patients (efficacy 100%). From the 4th to the 24th hour, pain remained absent in 11 (enucleation 10 cases and evisceration 1 case) of the 31 patients and no drug was used. In 20 patients (enucleation 7 cases and evisceration 13 cases), pain appeared between the 4th and the 10th hour and patients were relieved by paracetamol alone in 14 cases (enucleation 6 cases and evisceration 8 cases) or by its association with nalbuphine in 5 cases (enucleation 1 case and evisceration 4 cases). In one patient (evisceration) the association of the drugs was uneffective. CONCLUSION: Peribulbar anesthesia is safe and generates major postoperative analgesia so we suggest to offer that technique to patients undergoing evisceration or enucleation.

Acetaminophen↗
PubMed1988

Implant extrusion in eviscerations.

Wills Eye Hospital records for the ten-year period 1973-1983 were examined to compare the extrusion rate of implants from the scleral cavity after evisceration with the rate from Tenon's capsule after enucleation. Seventy-one consecutive extruding-implant surgical cases were examined; 60 (85%) occurred in sockets that had been previously enucleated and 11 (15%) in eviscerated eyes. In the same time period, there were 997 (95%) enucleations and 48 (5%) eviscerations. Fifteen percent of implant extrusions occurred in eviscerated sockets, for a 22% extrusion rate, compared with a 6% extrusion rate after enucleation. In this study, the frequency of extrusions was higher in eviscerations, although many variables, not taken into considerations here, might alter this ratio.

Burns, Chemical↗