Enucleation question - doctor wants to sew eyelids shut

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Enucleation question - doctor wants to sew eyelids shut

Unread post by ferramc » Sat Mar 02, 2013 12:17 am


I'm a new member. I've been blind in my right eye for 35 years (retina detachments) and it's about time to have it removed. I recently moved to Michigan so I am faced with doing this with a new doctor. I've got two choices, Dr Kahana (Kellogg Eye Center) or Dr Evan Black (facial works). One of the two doctors has said he wants to sew my eyelid shut for 4 weeks after the surgery. I've never heard of this. Can anyone provide guidance? Also, I've met with one ocularist who will create my new eye but does it in a day. Is that possible with a true 'custom' eye? Thanks for your help.

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Re: Enucleation question - doctor wants to sew eyelids shut

Unread post by auntlisa » Sat Mar 02, 2013 2:15 am

Hi ferra, and welcome aboard!!

I still have my native eye, so I can't speak to the surgical question. Cslonim, our resident oculoplastic surgeon, may have some good insights for you.

That said, I do have a scleral shell. Which is basically a prosthetic that rides in front of a present (in my case damaged and shrunken) eye instead of a removed one. It was made in a single day that consisted of 3 visits to the office. The first in the morning to make the mold; the second after lunch to verify fit, place the pupil and paint the iris and veins; and the third at the tail end of the day to pick up the final product.

It is a masterpiece. I cried when I looked in the mirror the first time. He's in Nebraska or I'd recommend him to you with zero hesitation.

If you search my posts you'll see how hesitant I was to even get a shell in the first place, so I know your concerns. Not to worry just because it's all done in a day.
38/F Diabetic Retinopathy both eyes 7/04, both blind thru 11/04
L=20/30, glaucoma 2013 R=Blind/shrunken/scleral shell 9/2010

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Re: Enucleation question - doctor wants to sew eyelids shut

Unread post by chemgal » Sat Mar 02, 2013 2:51 am


I had my eyelids stitched to a rolled up piece of cotton for a week. It acted like a bumper of sorts. I had no idea it was even done. It didn't feel weird or cause any discomfort. Although, I will say after 5 years of surgeries and procedures, when my husband saw it, it is the only time he had to sit down. I don't think anyone here has ever mentioned having it sewn shut for 4 weeks though. I am betting Cslonim will be able to tell you why it may have been suggested.

As for your prosthetic, one day is typical. But plan on being there ALL day. It is a long day, very tiring, your socket will be irritated. But, if you have a good ocularist, it will be worth it. I arrived at Jahrling's office in Boston early on the day I had mine done. Joyce did the mold and then I sat there while Eric painted my new iris. Then they put my conformer back in and I left to get something to eat while they made the eye. I returned to the office and they put the eye in and out, to check for fit and adjustments. I left again to get something to eat and then returned again for final fitting, a lesson on removing it and putting it in and directions on care. It was an entire day, but so worth it. My prosthesis is amazing. The only way you can tell which eye is fake is due to some of the damage to the surrounding tissue. But if someone where to look only at the eyeball part, they would never know. Eric is extremely talented and the iris he painted has depth to it, even when I take it out and look at it and KNOW that it is a flat disk baked on, it appears to have layers of color and highlight.

I believe I wrote about my experience getting the prosthesis made in more detail and it was used in one of the informational posts.

Hope this helps!
Left eye damaged due to parasitic infection 2007. Enucleation November 3, 2011.

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Re: Enucleation question - doctor wants to sew eyelids shut

Unread post by JANELLE » Sat Mar 02, 2013 3:45 am

It's not uncommon but not all doctors do it and it can depend on the situation. My first enucleation did not have my eyelid sewn shut. My second surgery to remove my implant and put in a fat graft (I'm unusual because I had 2surgeries. Most people just need one.) And that doctor stitched my eyelid shut. It was not uncomfortable. I wouldn't think to much about it. I had disolvable stitches and it took about 3 weeks for both stitches to dissolve.

I think it sounds worse that it is.
Female 50's, Enucleation due to Complications from Retinal Detachment, Fat Graft

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Re: Enucleation question - doctor wants to sew eyelids shut

Unread post by cslonim » Sat Mar 02, 2013 4:09 am

as you can see from the responses from some of the losteye contributors, some surgeons sew the eyelids closed and others do not. Some leave the stitch in for one week and others for 3-4 weeks. The purpose of sewing the eyelids closed is to keep pressure on the orbital contents during the postoperative period which helps reduce the swelling and reduce the bleeding (reduces oozing) and keeps the conformer from popping out. I do not sew the eyelids shut after my enucleations or eviscerations. On occasion, I will have a patient with significant swelling which causes the conformer to pop out. I warn my patients ahead of time that this might occur. If this happens, we wait for the swelling to resolve and then I put the conformer back in and they continue their postoperative care. After more than 30 years and hundreds and hundreds of enucleations, I still have not found a need to sew the eyelids shut. The discomfort from stitched eyelids typically occurs if there is postoperative swelling which pushes the conformer against the eyelids that have a stitch holding them together. This can be uncomfortable. The discomfort is usually in the area of the stitch and not the socket. Good luck.
oculoplastic surgeon
tampa, florida

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Re: Enucleation question - doctor wants to sew eyelids shut

Unread post by Irish_In_Oz » Sat Mar 02, 2013 5:09 am

Hi Welcome to Le; great people who care and share live here. My specialist also doesn't sew eyelid shut; since being here I've found around the world things are generally the same but some tiny difference. My conformer had holes in it for drops to take care of the socket during healing. I woke up with implant done; and a thick cup covering over the eye and a large pressure bandage around that side and over the head. I got my prosthetic 8 weeks later; all good. Mine was 2 days; first the mould then it was triple baked and polished; next day paint job. It was done this way because he was only 5 mins from my home. I think if people travel long distances the occularlist tries to accommodate them in 1 day. I hope the op goes well; I will put up a list we've put together for before and after. cheers vera
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Re: Enucleation question - doctor wants to sew eyelids shut

Unread post by KEITH DOUG » Sat Mar 02, 2013 12:02 pm

emm well thats a new one to me,, like irish said also,,,
i had surgery .the heavy duty bandage was on 1 day....
when it was removed , my eye socket had a conformer in it ( similar to a contact lense to aid healing) and the eye lids shut and closed,,
Enucleation March 2010 london uk

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Re: Enucleation question - doctor wants to sew eyelids shut

Unread post by ferramc » Sat Mar 02, 2013 1:28 pm

Thanks to all who replied. I've dealt with numerous eye problems and complications since I was 13 and had my first retina detachment (I have a connective tissue disorder). I thought I was ready for having my eye removed, but doing so with unknown doctors is turning out to be tougher than I thought. I really appreciate your comments and support.

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Re: Enucleation question - doctor wants to sew eyelids shut

Unread post by ferramc » Mon Mar 11, 2013 11:24 pm

I decided to go with the Dr Black. My surgery is scheduled for early next month. I have mixed emotions about the whole process. I've been living with a somewhat deformed eye for the past 35 years (too many surgeries as a teen) and you would think I would be happy as the replacement will look better than my blind eye, but that's not the case. I now find myself grateful that I had the 'bad eye' as long as I did.

Anyway, thanks again to those who responded and offered me guidance.

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