Name of the Procedure:

Ocular Implant Placement (L8610) Common name(s): Ocular prosthesis, artificial eye, eye implant. Technical/Medical term: Ocular implant insertion.

Summary

An ocular implant procedure involves the surgical insertion of an artificial device to replace a missing or damaged eye. This device helps restore the appearance and, in some cases, limited functionality of the eye.

Purpose

Medical Conditions or Problems Addressed:

• Severe eye trauma or injury.
• Loss of an eye due to disease, such as glaucoma.
• Congenital absence or severe malformation of the eye.
• Removal of the eye (enucleation or evisceration) due to cancer or other severe conditions.

Goals or Expected Outcomes:

• Restoration of the cosmetic appearance of the eye.
• Potential improvement of the eye socket's health and structure.
• Enhanced quality of life and self-esteem.

Indications

Specific Symptoms or Conditions:

• A missing eye or severe deformity of the eye.
• Anophthalmia (absence of the eye).
• Cosmetic necessity following enucleation or evisceration.

Patient Criteria:

• Healthy enough to undergo surgery.
• Adequate eye socket anatomy for implant placement.
• Post-surgical healing capacity evaluated and deemed sufficient.

Preparation

Pre-Procedure Instructions:

• Fasting for a specified number of hours before surgery.
• Adjustments to current medications, especially blood thinners.
• Informing the surgeon of any allergies or medical conditions.

Diagnostic Tests/Assessments:

• Thorough eye and socket examination.
• Imaging tests such as CT or MRI, if required.
• General health assessment to ensure fitness for surgery.

Procedure Description

Detailed Steps:

1. Anesthesia: Administer regional or general anesthesia.
2. Incision: Make a small incision in the conjunctiva or inside the existing eye socket.
3. Socket Preparation: Shape or remodel the eye socket if necessary.
4. Implant Placement: Position the ocular implant in the eye socket.
5. Closure: Sew the incision and place a conformer (temporary prosthetic) to maintain the shape.

Tools and Equipment:

• Surgical scalpel.
• Ocular implant devices.
• Sterile sutures.
• Conformer for shaping.

Anesthesia or Sedation:

• Local anesthesia, sedation, or general anesthesia, depending on patient and procedure specifics.

Duration

Typically takes about 1 to 2 hours.

Setting

Performed in a hospital or an accredited surgical center.

Personnel

• Ophthalmic surgeon.
• Anesthesiologist.
• Surgical nurses and assistants.

Risks and Complications

Common Risks:

• Infection at the surgical site.
• Implant displacement or extrusion.
• Persistent discomfort or pain.

Rare Risks:

• Severe allergic reaction to anesthesia.
• Excessive bleeding or hematoma formation.
• Poor healing or rejection of the implant.

Management:

• Use of antibiotics for infection.
• Immediate medical attention for severe allergic reactions.
• Regular follow-up and monitoring for implant displacement.

Benefits

Expected Benefits:

• Improved cosmetic appearance.
• Enhanced emotional well-being and self-esteem.

Realization:

• Immediate in terms of appearance, although some benefits may become more evident as healing progresses.

Recovery

Post-Procedure Care:

• Application of prescribed eye drops or ointments.
• Instructions on how to clean and care for the surgical site.
• Wearing an eye patch, if recommended.

Expected Recovery Time:

• Initial healing in 1-2 weeks.
• Full recovery and final prosthesis fitting may take several months.

Restrictions/ Follow-Up:

• Avoid strenuous activities initially.
• Regular follow-up visits for monitoring and adjustments.

Alternatives

Other Treatment Options:

• Use of an external ocular prosthesis (artificial eye worn over the eye socket).
• Orbital reconstruction surgery.

Pros and Cons:

• External prosthesis: Less invasive but might not integrate as well cosmetically.
• Orbital reconstruction: More involved surgical procedures but can provide enhanced structural results.

Patient Experience

During the Procedure:

• Patients will be under anesthesia, so they should not feel pain.

After the Procedure:

• Some discomfort, swelling, and bruising are normal.
• Pain management with prescribed medications.
• Gradual improvement in comfort and appearance as healing progresses.