Medical & Surgical Ophthalmology

Orbital surgery

In case of severe injuries of the eye globe or malignant tumors, it is necessary to perform enucleation or evisceration. After the eye globe has been removed, it is possible to place an intraocular prosthesis, which imitates the presence of the eye globe.

Intraocular prosthesis on the right eye in a dog
Intraocular prosthesis in the right eye socket

We use orbital exploratory surgery to remove foreign bodies or neoplasms.

Enucleation or prosthesis?

(What to do when the eye is blind and painful?)

There are many eye diseases that lead to irreversible vision loss. If the eye has permanently lost its function, is painful, and poses a danger to your pet’s health, then removal of that eye globe is necessary. Because the eye is a well-innervated organ, uncontrolled inflammation or uncontrolled eye pressure are the cause of long-lasting and continuous sharp or dull pain (such as migraines or toothaches).

Intraocular prosthetics or eye globe removal? What is the difference, what are the advantages and disadvantages of these procedures? We will discuss this topic below.

Eye globe removal (enucleation) has its positive aspects:

  • The surgery time is short. Removal of the eyeball can be done within 10-15 minutes.
  • Low probability of complications both during the surgery and in the postoperative period.
  • Short postoperative care, only 5-7 days after the operation, after which the patient does not require any special care.

Removal of the eye globe allows you to obtain complete material for histopathology evaluation, if necessary.

Eye globe removal has only one downside:

  • cosmetic defect due to the absence of the eye.

Intraocular prosthetics is a surgery by provides an aesthetically satisfying result and meets the wishes of the owner – to have a dog with a familiar “face”, and successfully removes the source of pain. In fact, the intraocular prosthetic is an operation that is necessary exclusively for the owner, and not for the dog or cat. The essence of intraocular prosthetics is the following: in severe diseases of the eye globe, the source of the disease is the internal contents of the eye. The eye consists of several membranes. The outer connective tissue of the eye consists of the cornea and sclera, which are often not involved in the disease process because the disease mainly affects the internal structures of the eye. By eliminating the source of the disease, it is possible to stabilize the condition of the eye without removing the outer membrane of the eye. After removing all the internal structures of the eye globe, a silicone prosthesis is installed in their place, which fills the inside of the eye socket and maintains its shape. On the outside, the prosthesis is covered with the remaining connective tissue membrane of the eye – the cornea and sclera. That’s how we get a dog’s eye that is no different, or slightly different from another, healthy eye.

Compared to eye globe removal, intraocular prosthetics have some disadvantages:

  • Longer postoperative period. The patient needs more intensive care for about 14 days. The postoperative period lasts up to 45 days.
  • This is a more expensive procedure than enucleation.

There is a higher risk of postoperative complications compared to the removal of the eyeball. These complications can be:

  • Reactions to the prosthesis itself. Sometimes corneal fibrosis occurs and then the operated eye looks different from the healthy one, in terms of color change.
  • Development of a corneal ulcer because the innervation of the cornea is disturbed.
  • Long-term complications that are not directly related to prosthetics, but are related to the structures of the eye that are retained (eg, eyelid tumor, dry eye disease, etc. may develop).

Whether enucleation or placement of an intraocular prosthesis will be performed depends on the wishes of the owner and the condition of the eye globe before the surgery. In the best of circumstances, eye globe prosthetics can be an excellent choice for both the patient and the owner. In some cases, it is better to refuse prosthetics. For example, if it is clear that an eye with a prosthesis will require special care for the rest of its life (this surgery is not recommended for Pugs or Pekingese, because they have a lot of additional eye problems that affect the success of surgery).

a dog with an artificial eye
Photo of the dog after placing the intraocular prosthesis in the right eye socket. There is no difference between the prosthetic eye and the left eye
eye after intraocular prosthesis
Photograph of the dog after the placement of the intraocular prosthesis. Due to corneal fibrosis, the color of the eye is bluish