Enucleation.

A canine patient was admitted into the hospital with the history of road traffic accident in which its left eye sustained severe trauma with clinical presentations of damaged hemorrhagic globe, corneal rupture and severe periocular swelling.

Since the injury was severe with irreversible ocular destruction leading to disruption of the visual function and risk of infection, transpalpebral enucleation method was indicated.

Enucleation is the surgical removal of the globe without entering the conjunctival sac thereby minimizing the spread of neoplastic or infectious materials into the orbit. Hence, the technique is commonly recommended in cases of severe infection,trauma or neoplasia. 

Before the surgical intervention, vital parameters of the patient was eamined and stabilized. NSAIDs are administered preoperatively since the procedure is painful. The surgery was performed under general anesthesia(gaseous anesthesia) and proceeded with a temporary tarsorrhaphy by suturing the upper and lower eyelids to close the palpebral fissure, preventing the exposure of the underlying orbital contents. An elliptical deep incision was made around the closed eyelid margins followed by blunt dissection into the orbit. Intra-operatively, the optic nerves and vessels were carefully ligated and isolated to free the globe and prevent hemorrhage. After the excision of the globe, the orbital cavity was inspected for bleeding and lavaged with normal saline. 

Closure of the wound was performed in layers and simple interuptted suture pattern was applied on the skin. Post-operative therapy includes administration of NSAIDs to manage pain and antibiotics to prevent infection.

The doctor stated that prognosis of enucleation is generally excellent, although the vision is permanently impaired on the affected eye, dogs usually adapt well to monocular vision.