SAEVA Congress 2018 Proceedings | 12-15 February 2018 | ATKV Goudini Spa
An excenteration would be chosen when:
• There is a ruptured globe following panophthalmitis or severe corneal
laceration/iris prolapse or where there may be a near penetrating
descemetocele on an infected globe that could easily rupture during the
surgical procedure.
•
Corneal and or conjunctival surface neoplasia eg: squamous cell
carcinoma
The final outcomes on how the globe is being managed will obviously have a
bearing in what type of prosthetic device is available to the patient. An
intraocular prosthetic silicon ball can only be placed into a globe that is not
infected, inflamed and must have a healthy cornea as the prosthetic will buffer
up against the corneal endothelium. End stage glaucoma is probably the most
common presenting problem for this option.
An intraorbital prosthetic can be placed into any clean orbit following either an
excenteration or enucleation. Medical grade silicone is one of the least bioreactive
materials available for medical usage today and thus makes an excellent source for
ocular prostheses.
Intraorbital prosthesis: Many cases of severe ocular disease may result in an
enucleation or excenteration of the globe. In most cases it is a traumatic experience,
perhaps more so for the owners of our patients than for the animals themselves.
These surgical procedures are concluded by suturing the skin closed over the orbital
cavity but as the wound heals, a rather obvious and often cosmetically poor
indentation of skin results.
In performing orbital surgery, part of our responsibility is to create as good a
postsurgical appearance as possible. Cosmetics may be important for some owners.
Most enucleations performed on horses, dogs and cats are done using the
transpalpebral technique. To be aesthetically successful, this method requires the
placement of some type of orbital implant.
A range of silicone implants is now available and these implants can be placed in the
orbit before the skin wound is closed. A conforming equine model is available for
intraorbital use only. This has been given the nickname of a “top hat” prosthesis,
based on its shape:
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