INTRAOCULAR SILICONE BALL IMPLANTATION AFTER EVISCERATION IN A SLOW LORIS (NYCTICEBUS COUCANG).

A slow loris, Nycticebus coucang , was brought to Ji Dong Beom Animal Hospital from the National Institute of Ecology due to globe enlargement and frequent blepharospasm of the right eye. Ophthalmic diagnoses included glaucoma with posterior lens luxation and cataract. Because this animal was on exhibition at the National Institute of Ecology, preservation of the eyeball by intraocular silicone implantation following evisceration rather than enucleation was selected. Before the surgery, examination of the normal left eye was performed using Retcam and spectral domain optical coherence tomography. Three months later, the globe size was almost the same as the left eye; however, corneal edema remained.

Histopathological study of the causes for failure of intrascleral prostheses in dogs and cats.

OBJECTIVE: To characterize the histopathological causes for failure of intrascleral prosthesis placement in dogs and cats. PROCEDURES: The Comparative Ocular Pathology Laboratory of Wisconsin database was searched to find canine and feline evisceration samples that were diagnosed with neoplasia. A second population included canine and feline scleral shells that were removed after an evisceration surgery had been performed. The causes for removal were divided into: neoplasia, corneal abnormalities, and other causes. RESULTS: In dogs, 163 of 1985 evisceration samples (8.21%) contained a neoplasm, whereas 17 of 88 (19.31%) evisceration samples in cats contained a neoplasm. In dogs, severe corneal disease was diagnosed in 38 of 80 scleral shells (46.25%) and neoplasia was diagnosed in 31 of 80 scleral shells (38.75%). Malignant melanoma was the most frequently diagnosed tumor, in 14 of 31 scleral shells. In cats, eight of 12 scleral shells contained a tumor (66.7%), with feline diffuse iris melanoma being diagnosed most commonly (six of eight shells). Two of 12 feline scleral shells had severe corneal disease (16.7%). Epithelial downgrowth, lining the inner aspect of the fibrous tunic, was seen in 14 of 38 canine scleral shells and in two of two feline scleral shells with severe corneal disease. CONCLUSIONS: Severe corneal disease and neoplasia are the most common causes for intrascleral prosthesis failure in dogs, whereas neoplasia is the single most common cause for intrascleral prosthesis failure in cats.

A technique for evisceration as an alternative to enucleation in birds of prey: 19 cases.

Ocular trauma is common in birds of prey presented to wildlife clinics and rehabilitation centers. Enucleation is the procedure most commonly described for treatment of end-stage ocular disease or chronically painful eyes in birds; however, there are several disadvantages and risks to this procedure. While evisceration has been suggested as an alternative, it has not been described for multiple cases or with long-term follow-up data in birds of prey. This report details an evisceration technique performed in 5 captive birds of prey of 4 different species (1 eastern screech owl [Megascops asio], 1 great horned owl [Bubo virginianus], 2 red-tailed hawks [Buteo jamaicensis], and 1 bald eagle [Haliaeetus leucocephalus]) with long-term follow-up information. In addition, this report describes 14 cases of free-living owls of 3 different species (1 great horned owl, 4 barred owls [Strix varia], and 9 eastern screech owls) on which this technique was performed from 2004 to 2011 and which were subsequently released to the wild. Because of the limited risk of complications and the less-severe disruption of facial symmetry, which may be particularly important in owls that are candidates for release to the wild, evisceration should be considered over enucleation in birds of prey that require surgical intervention for the management of severe sequelae to ocular trauma.

Comparison of orbital prosthesis motility following enucleation or evisceration with sclerotomy with or without a motility coupling post in dogs.

OBJECTIVE: To evaluate motility of silicone orbital implants and corneoscleral prostheses, with and without use of a motility coupling post (MCP) in dogs. ANIMALS STUDIED: Eighteen mixed-breed dogs. PROCEDURES: The motility of an orbital silicone implant and corneoscleral prosthesis after enucleation (n = 6), evisceration (n = 6), or use of a MCP with evisceration (n = 6) in dogs were compared. One eye from each dog had surgery whereas the opposite eye was used as a control. Clinical evaluations were performed three times a week. Histopathology of the orbital tissues was performed 8 and 12 weeks after surgery. RESULTS: Implant motility in dogs with evisceration (vertical movement [VM] 8.04 +/- 2.13; horizontal movement [HM] 11 +/- 3.05) and evisceration with MCP (VM 9.61 +/- 1.59); HM was significantly greater than the enucleation group (VM 0.51 +/- 0.5; HM 1.22 +/- 0.68) (P < 0.01). Prosthetic motility in dogs with evisceration with MCP was significantly greater than in dogs with evisceration; dogs with evisceration had significantly greater motility than dogs with enucleation (P < 0.01). No postoperative complications were observed in any of the groups. No significant abnormalities were noted on histopathology. CONCLUSIONS: MCP placement in silicone orbital implants significantly enhanced the prosthetic motility in dogs. This study supports the use of MCP in silicone orbital implants to enhance corneoscleral prosthesis motility and cosmetics in dogs.

Successful chemical ablation of an intraorbital cyst caused by an eyelid injury and iatrogenic ankyloblepharon formation in a duck.

CASE DESCRIPTION A client-owned 2-year-old 1.8-kg (4-lb) male pet Rouen duck (Anas platyrhynchos domesticus) was evaluated because of severe swelling around the left eye following traumatic injury to the upper and lower eyelids and 2 associated surgeries that resulted in the removal of the entire upper and lower eyelid margins. CLINICAL FINDINGS At initial evaluation, ankyloblepharon of the left eye was observed, with no upper or lower eyelid margins and a large, round, fluctuant subcutaneous mass over the left orbit. Orbital exploration and histologic examination revealed a benign cyst consisting of fibrous tissue, conjunctiva, and skeletal muscle bundles. Bacterial culture of cystic fluid yielded few Staphylococcus delphini. TREATMENT AND OUTCOME Excision of the cyst and evisceration of the left globe were performed, and once daily treatment with orally administered enrofloxacin suspension (12.6 mg/kg [5.7 mg/lb]) and meloxicam (1 mg/kg [0.45 mg/lb]) was initiated. Over the next 4 days, the cyst redeveloped and progressively enlarged. Accumulated fluid was aspirated from the cyst, and 20 mg of gentamicin was injected intraorbitally with ultrasound guidance. Over the subsequent 27-month period, no recurrence of clinical signs or adverse effects were reported by the owner. CLINICAL RELEVANCE To the authors' knowledge, this is the first report of cyst formation after adnexal injury and evisceration in birds and its successful treatment with intralesional gentamicin injection. Findings emphasized the importance of preserving lacrimal puncta during adnexal or eye removal surgeries in birds. Intralesional injection of gentamicin with the goal of destroying fluid-producing cells may be a safe and effective way to treat intraorbital cysts in birds and other species, although additional research would be required to confirm this.

Unilateral evisceration of an eye following cornea and lens perforation in a sulfur-crested cockatoo (Cacatua galerita).

A 24-year old male sulfur-crested Cockatoo (Cacatua galerita) was presented with a subacute perforation of the cornea without involvement of the lens. The bird was treated conservatively and the eye remained quiescent up to a second traumatic corneal perforation associated with a lens capsule rupture 15 months later. Due to the second perforating trauma of an already blind eye involving the lens, evisceration of the eye was performed. Two months after surgery the cosmetic result was excellent. Treatment options for perforating ocular traumas in captive birds are discussed in detail.

Eye Removal Surgeries in Exotic Pets.

This article covers considerations and techniques of eye removal surgeries in exotic pets. After issues including surgical indications, anesthesia, patient preparation, and instrumentation are explored, surgical techniques are described. Enucleation/exenteration and modified evisceration are discussed, with species-specific nuances of small mammals, birds, reptiles, snakes, amphibians, and fish highlighted.

Intraocular silicone prosthesis implantation in eyes of dogs and a cat with intraocular neoplasia: nine cases (1983-1994).

OBJECTIVE: To determine the outcome of implantation of an intraocular silicone prosthesis (ISP) in the eyes of dogs and cats with intraocular neoplasia. DESIGN: Retrospective case series. ANIMALS: Eight dogs and 1 cat with histologically confirmed intraocular neoplasia. PROCEDURE: Signalment, clinical signs before and after surgery, results of microscopic examination of eviscerated intraocular tissues, follow-up information, and necropsy findings, if available, were recorded for each animal. RESULTS: Five dogs and 1 cat had primary intraocular neoplasms. Two of the dogs developed regrowth of the neoplasm around the ISP 6 to 24 months after implantation, and the eyes were enucleated. The cat developed signs compatible with systemic metastasis 4 years after surgery and was euthanatized. Three dogs had multicentric or metastatic neoplasia involving the eye. Two of these dogs were euthanatized because of their systemic disease 1.5 to 7 months after ISP implantation. The third dog is alive without evidence of regrowth 3 years after surgery. CLINICAL IMPLICATION: Intraocular neoplasia is not an absolute contraindication to ISP implantation.

A new type of intraocular prosthesis for dogs.

A simple technique is described in which sterile silicone oil (viscosity 350 cSt) was injected into the globe of an eviscerated eye with an intact cornea and sclera; the volume injected was calculated from the formula 3/4 pi r3 where 'r' was the horizontal corneal diameter. After induction of general anaesthesia and routine preparation of the surgical site, the globe was eviscerated by using a transscleral or transcorneal approach. The procedure was carried out in five dogs with follow-ups ranging between 19 and 27 months. None of the eyes developed postoperative complications. In one dog, more silicone oil had to be injected 10 days after surgery to increase the size of the globe to match the other eye. The intraocular contents were removed more easily by using the transcorneal approach, which also resulted in a perfect adjustment and virtually eliminated the possibility of leakage of silicone oil, than by a transscleral approach. The dogs responded extremely well and their owners were satisfied with the cosmetic appearance of their pets.

Experimental acrylonitrile butadiene styrene and polyamide evisceration implant: a rabbit clinical and histopathology study / Estudo clínico e histopatológico em coelhos eviscerados com utilização de implantes de poliamida e acrilonitrila butadieno estireno

The purpose of this study was to evaluate acrylonitrile butadiene styrene (ABS) and polyamide implants in rabbits submitted to evisceration at the macroscopic and microstructure level and to assess clinical response and histopathological changes as well. For the experimental study implants of 12mm diameter were prepared by rapid prototyping, weighed and the outer and inner surfaces evaluated macroscopically and by electron microscopy. In addition, a compression test was performed and ultrastructural damage was then determined. After evisceration of the left eyeball, nine New Zealand rabbits received ABS implants and nine others received polyamide implants. The animals were assessed daily for 15 days after surgery and every seven days until the end of the study (90 days). Histopathological evaluation was performed at 15, 45 and 90 days after surgery. The ABS implants weighed approximately 0.44g, while the polyamide ones weighed 0.61g. Scanning electron microscopy demonstrated that the ABS implants had regular-sized, equidistant micropores, while the polyamide ones showed micropores of various sizes. The force required to fracture the ABS implant was 14.39 ±0.60 Mpa, while for the polyamide one, it was 16.80 ±1.05 Mpa. Fifteen days after surgery, we observed centripetal tissue infiltration and scarce inflammatory infiltrate. Implants may be used in the filling of anophthalmic cavities, because they are inert, biocompatible and allow tissue integration.(AU)

Avaliou-se a macroscopia, a microestrutura, a resposta clínica e histopatológica de implantes de acrilonitrila butadieno estireno (ABS) e poliamida em coelhos submetidos à evisceração. Para o estudo experimental, os implantes foram elaborados por meio de prototipagem rápida, com 12mm de diâmetro, pesados e tiveram suas superfícies avaliadas macroscopicamente e por microscopia eletrônica de varredura. Adicionalmente, foi realizado ensaio de compressão para determinar a força necessária para fraturar os implantes. Após a evisceração do olho esquerdo, nove coelhos da raça Nova Zelândia receberam implantes de poliamida e nove outros receberam implantes de ABS. Os animais foram avaliados diariamente nos primeiros 15 dias após a cirurgia e a cada sete dias até o fim do período experimental (90 dias). Avaliação histopatológica foi realizada aos 15, 45 e 90 dias após a cirurgia. Os implantes de ABS pesaram 0,44g, e os de poliamida 0,61g. A microscopia eletrônica de varredura demonstrou que os implantes de ABS eram formados por microporos equidistantes, enquanto os de poliamida apresentavam microporos de vários tamanhos. A força necessária para fraturar os implantes de ABS foi de 14.39±0.60 Mpa, enquanto para os de poliamida foi de 16.80±1.05Mpa. Quinze dias após a cirurgia, foi observada infiltração fibrovascular centrípeta. Os implantes podem ser utilizados para correção de cavidades anoftálmicas por se mostrarem inertes, biocompatíveis e permitirem a infiltração tecidual.(AU)

Corneal sensitivity and aqueous tear production in dogs undergoing evisceration with intraocular prosthesis placement.

OBJECTIVE: To determine whether there is an association between evisceration with intraocular prosthesis placement via a dorsal scleral approach and decreased corneal sensitivity or aqueous tear production in dogs. DESIGN: Prospective study. PROCEDURE: Twenty-one dogs scheduled to undergo unilateral evisceration with intraocular prosthesis, and with a normal normotensive contralateral eye, based on slit-lamp biomicroscopy, indirect ophthalmoscopy and applanation tonometry, were included in the study. Central corneal sensitivity was measured with a Cochet-Bonnet esthesiometer prior to (week 0) and 2, 7, 14 and 28 weeks following surgery. Other pre- and postoperative data collected were Schirmer's tear test (STT I), Schirmer's tear test with topical anesthesia (STT II), corneal fluorescein retention, and intraocular pressure (IOP; postoperative control eye only). Axial globe length was determined for both eyes. Scleral incision length in the surgery eye was also recorded. RESULTS: Corneal sensitivity was significantly lower in eyes undergoing evisceration with intraocular prosthesis than in control eyes both preoperatively and postoperatively at all time points. There was no significant difference between preoperative and postoperative corneal sensitivity within the two groups. There was no significant difference in STT I or STT II-values between control eyes and surgery eyes preoperatively. There was a significant difference between preoperative and 2-week postoperative STT I in the surgery eye. There was a significant difference between the preoperative and 28-week postoperative STT II in the surgery eye. The 28-week postoperative STT I-values differed significantly between control and surgery eyes. Corneal sensitivity tended to decrease with increased degree of buphthalmos or with increased scleral incision length, although neither relationship was statistically significant. CONCLUSIONS: Eyes that have sustained chronically elevated intraocular pressure had decreased axial corneal sensitivity compared to normal eyes, which persisted even after intraocular pressure was reduced. The presence of buphthalmos appeared to be a factor in globes developing decreased corneal sensitivity. Evisceration via a dorsal scleral incision did not result in a significant further reduction in axial corneal sensitivity. A mild reduction in aqueous tear production occurred over time in globes following evisceration with intraocular prosthesis.