65093 Evisceration of ocular contents; with implant

Name of the Procedure:

Evisceration of Ocular Contents with Implant (sometimes referred to as Ocular Evisceration or Eye Evisceration)

Summary

Evisceration of ocular contents with implant is a surgical procedure where the internal contents of the eye are removed, while the outer shell and surrounding structures are left intact. An implant is then inserted into the eye socket to maintain its shape and provide better cosmetic results.

Purpose

This procedure is typically done to relieve pain or prevent the spread of infection in a blind and painful eye. It also aims to improve the appearance of the affected eye socket and support future use of a prosthetic eye.

Indications

• Severe eye trauma
• Infections that are unresponsive to other treatments
• Blind, painful eye due to glaucoma or other conditions
• Certain intraocular tumors

Preparation

• Patients may need to fast for a few hours before the surgery.
• Current medications should be reviewed, with some possibly needing adjustment.
• Pre-operative assessments, such as blood tests and eye examinations, may be required.

Procedure Description

1. Anesthesia: General or local anesthesia is administered to ensure patient comfort.
2. Incision: A small incision is made in the conjunctiva.
3. Removal of Contents: The contents of the eyeball, including the cornea, iris, and internal tissues, are carefully removed.
4. Placement of Implant: An orbital implant is placed into the scleral shell to maintain the eye’s shape.
5. Closure: The conjunctiva is then sutured closed over the implant.
6. Dressing: The eye area is covered with a protective dressing.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

Evisceration of ocular contents with implant is usually performed in a hospital or an outpatient surgical center.

Personnel

The surgical team often includes:

• An ophthalmic surgeon
• An anesthesiologist
• Nursing staff
• Surgical assistants

Risks and Complications

• Infection
• Bleeding
• Implant displacement or extrusion
• Socket pain or discomfort
• Rarely, sympathetic ophthalmia (inflammation in the other eye)

Benefits

• Relief from chronic eye pain
• Prevention of spread of infection or disease
• Improved cosmetic appearance
• Better support for a prosthetic eye

Recovery

• Patients may need to rest and avoid strenuous activities for several weeks.
• Pain management typically includes prescribed analgesics.
• Regular follow-up appointments are necessary to monitor healing and implant position.
• Instructions will be provided on how to care for the eye area and the dressing.

Alternatives

• Enucleation (complete removal of the eyeball)
• Pain management without surgery (when appropriate)
• Observation in cases where the condition is non-progressive

Patient Experience

During the procedure, the patient will be under anesthesia and should not feel any pain. Post-surgery, mild to moderate pain can be expected, which is managed with medication. There may be swelling and bruising around the eye, which subsides over time. Most patients adapt well with notable cosmetic improvements and relief from their previous symptoms. Pain management and emotional support are important aspects of the post-operative care.