Reconstructive surgery

The intervention consists of replacing the blind eye while keeping the outer envelope of the eye called the sclera. A ball is positioned inside the sclera to keep volume. A shaper adapted to the color of the iris is then positioned while waiting for the production of a prosthesis.

Duration: 1h30 with overnight hospitalization

General anaesthesia

Procedure:

Anesthesia consultation before surgery
Fasting on the day of the operation
Exit the day after the intervention with a bandage on the eye
Postoperative follow-up:

Do not play sports or put your head under water for a week
Antibiotic therapy will be prescribed for a week
Care is carried out at home to redo the dressing daily for a week
Frequency of appointments:

D1: Appointment with Dr. Bela for monitoring
D7: dressing removal
M1: creation of a temporary prosthesis
M6: After complete healing, the ocular prosthetist manufactures a definitive custom-made prosthesis. This does not require manipulation on the part of the patient and all activities are possible. A polishing by the prosthetist is carried out every 6 months and a change every 5 years.

The intervention consists of replacing the blind eye without keeping the outer envelope of the eye called the sclera. A covered ball is positioned in the cavity, to keep volume. A shaper adapted to the color of the iris is then positioned while waiting for the production of a prosthesis.

Duration: 1h30 with overnight hospitalization

General anaesthesia

Procedure:

Anesthesia consultation before surgery
Fasting on the day of the operation
Exit the day after the intervention with a bandage on the eye
Postoperative follow-up:

Do not play sports or put your head under water for a week
Antibiotic therapy will be prescribed for a week
Care is carried out at home to redo the dressing daily for a week
Frequency of appointments:

D1: Appointment with Dr. Bela for monitoring
D7: dressing removal
M1: creation of a temporary prosthesis
M6: After complete healing, the ocular prosthetist manufactures a definitive custom-made prosthesis. This does not require manipulation on the part of the patient and all activities are possible. A polishing by the prosthetist is carried out every 6 months and a change every 5 years.

When the prosthetic ball is rejected by the body, replacing it with a new ball leads to too great a risk of secondary rejection. A dermofatty graft is then proposed.

This graft of skin (dermo) and fat (fatty) is taken from the patient himself, from a donor site rich in fat: abdomen or buttock. This graft will then replace the volume of the removed ball.

This volume is subject to a volume loss of approximately 20% within 3 months

Advantage: no risk of rejection.

Disadvantage: reduced mobility of the new prosthesis.

Duration: 1h30 with overnight hospitalization

General anaesthesia

Procedure:

Anesthesia consultation before surgery
Fasting on the day of the operation
Exit the day after the intervention with a bandage on the eye
Postoperative follow-up:

Do not play sports or put your head under water for a week
Antibiotic therapy will be prescribed for a week
Care is carried out at home to redo the dressing daily for a week
Frequency of appointments:

D1: Appointment with Dr. Bela for monitoring
D7: dressing removal
M1: creation of a temporary prosthesis
M6: After complete healing, the ocular prosthetist manufactures a definitive custom-made prosthesis. This does not require manipulation on the part of the patient and all activities are possible. A polishing by the prosthetist is carried out every 6 months and a change every 5 years.

When the evisceration cavity has retractions or scarred bands (symblepharons) in the blind spots of the eyelids, this leads to intolerance and instability of the prosthesis. Surgery is then performed to resect the flanges which are replaced by tissue taken from the patient himself, with a very close tissue: the oral mucosa (inside the lip or cheek).

Duration: 1h30 with overnight hospitalization

General anaesthesia

Procedure:

Anesthesia consultation before surgery
Fasting on the day of the operation
Exit the day after the intervention with a bandage on the eye. No sutures in the mouth
Postoperative follow-up:

Do not play sports or put your head under water for a week
Antibiotic therapy will be prescribed for a week
Liquid and cold food during the first week.
Care is carried out at home to redo the dressing daily for a week
Frequency of appointments:

D1: Appointment with Dr. Bela for monitoring
D7: dressing removal
M1: After complete healing, the ocular prosthetist adjusts a definitive custom-made prosthesis. This does not require manipulation on the part of the patient and all activities are possible. A polishing by the prosthetist is carried out every 6 months and a change every 5 years.

When the ball is in place, well tolerated by the patient but the evisceration operation is old, we observe a "enucleus syndrome". It is a melting of the fat around the ball with an infero-external rocking of the ball and an appearance of a sunken upper eyelid when the prosthesis is in place. A fat sample is therefore taken from the patient himself in order to reinject it around the ball in the orbit to restore the volumes lost over time.

A stable fat, i.e. little fluctuating with the weight of the patient, is taken: on the inside of the knees in women, on the abdomen in men.

This fat is removed using a 3mm diameter cannula and liposuction is performed leaving only a 3mm scar. This fat is then centrifuged to extract a "purified" fat. This fat is then reinjected around the ball and under the eyebrow using a 1 mm diameter cannula in order to restore the lost volumes and symmetrize the gaze with the contralateral side.

Duration: 1h30 with overnight hospitalization

General anaesthesia

Procedure:

Anesthesia consultation before surgery
Fasting on the day of the operation
Exit the day after the intervention with a bandage on the eye.
Postoperative follow-up:

Do not play sports or put your head under water for a week
Antibiotic therapy will be prescribed for a week
Care is carried out at home to redo the dressing daily for a week
Frequency of appointments:

D1: Appointment with Dr. Bela for monitoring
D7: removal of sutures
M3: The final results are visible at 3 months because this fat decreases by 20% within 3 months After complete healing, the ocular prosthetist adjusts the prosthesis to measure. This does not require manipulation on the part of the patient and all activities are possible. A polishing by the prosthetist is carried out every 6 months and a change every 5 years.