ENUCLEATION of an EYE (enucleatio bulbi, enucleatio oculi; lat. enucle-are to take a kernel, to enucleate) — surgery of removal of an eyeglobe.
The first mentioning of operational removal of an eye consider J. Lange's message made in 1555. To the middle of 19 century the equipment E was accepted. by capture and a pulling of an eyeglobe with a simultaneous section of the structures surrounding it. In 1841 Mr. O'Ferrall (J. M of O'Ferrall) and Bonn (A. Bonnet) independently from each other changed technology of operation, having suggested to make consistently a section of a conjunctiva, muscles of an eyeglobe and an optic nerve. In 1859 Arlt (Page F. R. Arlt) and in 1860 A. Gref described the equipment E., the most often applied and in a crust, time.
Indications to E. malignant intraocular tumors are; the gone blind eye with the severe not stopped pains, napr, at glaucoma (see); the traumatic iridocyclitis (see) with sharply expressed decrease in intraocular pressure which is not giving in to conservative treatment; sharply disfigured gone blind eye at impossibility of prosthetics. AA. apply also as a preventive measure at threat of a sympathetic ophthalmia (see).
The special preparation for surgery is not required. In the choice of anesthesia preference is given to an anesthesia, but in some cases also local anesthesia can be applied.
Make a circular section of a conjunctiva at a limb. Conjunctiva and tenonova capsule (vagina of an eyeglobe, T.) completely otsepa-rovyvat from a sclera. Scissors cut at first direct muscles of an eye at places of their attachment, then — slanting. The eyeglobe is fixed a clip for a stump of one of direct muscles and tighten kpered. The scissors started for an eyeglobe cross an optic nerve and take an eyeglobe. After carrying out a careful hemostasis put stitches on a conjunctiva.
Modifications of the equipment E. are caused by the aspiration to improve cosmetic effect of the subsequent prosthetics by implantation of a piece of the fatty tissue taken from the most sick, tinned cadaveric cartilaginous tissue, synthetic alloplastichesky materials in a cavity of the tenonovy capsule instead of an eyeglobe. Prosthetics is made in 4 — 5 days after E. (see the Prosthesis eye).
Refer local inflammatory processes, discrepancy of seams of a conjunctiva, rejection and shift of an implant to postoperative complications. Quite often in several weeks after E. the symptom complex characteristic of an anophthalmus develops: low-mobility of an eye prosthesis, its deep arrangement, retraction of an upper eyelid. In these cases make correction of defects by means of special surgical receptions.
Bibliography: Gundorova R. A. and
Peter and Paul G. A. The getting wounds and contusions of an eye, M., 1975; The Management of eye surgery, under the editorship of V. P. Odintsov and To. X. Orlova, t. 1, page 270, M. — L., 1933; Fox S. And, Ophthalmic plastic surgery, p. 538, N. Y.,
P. A. Gundorova.