EYE REMOVAL AND INTRASCLERAL PROSTHESIS (ISP)

Eye Removal

With eye removal the whole eye is removed along with the eyelid margins. The cut edges of the eyelids are then sutured closed. Healing takes about 2 weeks at which time the sutures are removed. Initially the area is quite swollen but this resolves over the first 2 weeks. With time the skin can sink into the hole created when the eye is removed. In short-haired dogs this is quite noticeable, it is less noticeable with long-haired dogs.

Eye Removal

*Newletter on Tips for removing an eye*

Intrascleral Prosthesis

With this procedure, the parts of the eye causing pain (inside the globe) are removed. A cut is made into the white of the eye (the sclera), all the contents are removed, and an implant is placed to fill the void. This implant sits inside the sclera and cornea. The size of the implant used matches the normal size of the eye, and enlarged eyes shrink down around the implant. After surgery a suture is placed in the eyelids to protect the eye whilst healing, this is usually removed 2-4 weeks after surgery.

Good Eye - You can see the iris and pupil

Both Eyes - A good result!

Prosthetic Eye - no eye structures visible

Inducer and the prosthetic ball

Eye Removal versus Intrascleral Prosthesis

The initial healing period is shorter with eye removal - 2 weeks versus 4 weeks with intrascleral prosthesis. Both conditions are mildly painful postoperatively for a couple of days and analgesics are given postoperatively. Some prosthesis cases develop ulceration in the postoperative period - this is usually prevented with the eyelid suture which is left in place for one month.

The long term complication rate of both procedures is very low. With eye removal there is less than a 1% chance of problems. These include infections in older animals related to dental disease, and tear production due to orbital tear-producing glands. Long term complications of intrascleral prosthesis surgery are also low, however it is still possible for the eye to develop corneal disease e.g. ulceration, or dry eye, however these are rare.

Compared to eye removal, intrascleral prosthesis surgery is a less traumatic surgery - as less tissues are cut into or removed.

Intrascleral prosthesis surgery produces a far more cosmetic result. The prosthesis usually turns a dark grey to black colour, with some becoming a more cloudy/blue colour. The eyelids are intact and blink normally. Most clients are very happy with the result of this surgery, and many comment that most people cannot tell that the prosthesis is a false eye.

Cloudy Prosthetic Eyes - Golden (Right), Cocker (Left) and Chihuahua (Left)

Dark ISPs

Post Operative Care

1. The surgery site must be kept clean of any discharge. Wipe the site gently with a cotton wool ball moistened with warm tap water. This may need to be done 2 - 3 times daily. Do not allow discharge to build up as this can delay healing.

2. Monitor the eye for any sign of discomfort; squinting, rubbing, discharge. Dissolving sutures are used, therefore suture removal is not required other than the eyelid suture.

3. Generally we check the surgical site 10-14 days after surgery.

4. An Elizabethan may be required if "Jessie" scratches at the eye but this is not common.

5. The temporary eyelid suture is removed 3-4 weeks after surgery.

6. Some cases may require a short (2-4 week) course of anti-inflammatory drops if the cornea becomes reactive with blood vessels. this is more likely to occur if the eye has been diseased for some time before the intrascleral prosthesis surgery.