Question for Chip Anderson on gross stuff

[drk]

Chip, I have a traumatic anophthalmia patient without prosthesis. I don't have access to his prior medical records, and the history is somewhat sketchy.

Per research, I know there are three types of procedures:

Evisceration, Enucleation, and Exenteration are the three main surgical techniques by which all or part of the orbital contents are removed. Evisceration is the removal of the contents of the globe while leaving the sclera and extraocular muscles intact. Enucleation is the removal of the eye from the orbit while preserving all other orbital structures. Exenteration is the most radical of the three procedures and involves removal of the eye, adnexa, and part of the bony orbit.


My questions, if you will:

Which do you see more of?

Can you tell the difference between an eviscerated globe and an implant?
If so, can you describe the appearance?

Thanks Chip.

[AdmiralKnight]

Evisceration? Damn. That's got to be the most morbid sounding name for a medical procedure I've ever heard.

[chip anderson]

As to your patient if the eye is quiet, not prone to high pressure or recurrent infections. A shell eye can be fitted without removal of the eye. Usually works very well as all muscles are still placed where God put them. Movement is usually excellent. Comfort is excellent if very well done.

As to your question:
I see more enucleations of various types. Can tell you more about the pros and cons of this.
Eviseration is seldom used today as most ophthalmologists seem to be afraid of leaving some corroidal tissue in the process. This is an excellent proceedure as all six muscles are left in the place God intended so movement, is excellent.

I have only seen a little exoneration and hope to see no more. This requires an exoprosthesis (lids, and possibly other facial parts). I don't do the lids or other facial parts and have made it a point not to learn how, would like to know but don't want to take up this work.

Let me know if you want to know more.

Chip