Mark Lombard, [14 Mar 2025 at 06:51:13]: I have a 4-year-old elephant calf with a stromal abscess which has burst through the cornea of the eye and now needs enucleation. Any advice on technique and after care would be appreciated. I am trying to avoid multiple knockdowns if possible. Gary Bauer, [14 Mar 2025 at 07:24:34]: Hi Mark. Perilimbal subconjunctival enucleation with standard lid margin resection, suturing and overlaying stent for 48 hours should do the job. Not sure if the calf can be handled, but a stent can be tied with a release knot and long suture to effect release after 48hrs. If not possible, complete intra-operative haemostasis (with no oozing) should negate the necessity of a stent. Good luck and let us know how it goes. As a side note, ruptured corneas can be repaired by grafting techniques if there are no contra-indications. Erik Verrynne, [14 Mar 2025 at 07:38:38]: Very interesting Gary. Thank you. How do you prevent the calf from fiddling with the stent and release knot? Or do they leave it alone in general? Gary Bauer, [14 Mar 2025 at 08:24:01]: Ellies obviously have more contra-indications than non-trunked species☺️. The problem is more rubbing against objects with the stent. In this case, particularly if not handleable, proper haemostasis sans stent would be the way to go. If it can be handled and managed, 24/2 supervision may work. I would be interested to hear of Mark's result. Initially, I never used stents, but I found that post-surgical swelling and possible orbital haematomas are practically eliminated if a stent is used. HO Reuter, 14 Mar 2025. Hi Gary, what about packing enucleated eye socket with eye ointment, mastitis ointment, Acrisulf, F10 ointment to fill dead space to prevent haematoma / infection? Gary Bauer, [14 Mar 2025 at 16:54:50]: Hi HO. I have never done that post-enucleation. Years ago in equine surgeries, some people used to pack the eye socket with A/G gauze strip and remove about 30 cm per day – this lasted about 3 to 4 days. I only use that when there is a specific indication - e.g. severe infectious orbititis, orbital abscess after trying to save an exophthalmic globe etc... Erik Verrynne, [14 Mar 2025 at 17:06:56]: Our standard procedure is to fill the socket with an acriflavine/ glycerine infused gauze strip and stitch the skin close, leaving a small opening in the medial corner with the tip of the gauze sticking out. This is removed 5-7 days later. HO Reuter, [14 Mar 2025 at 17:27:14]: I have used the acriflavine/glycerine gauze too. But if factors such as travelling huge distances or finding the animal again limit repeat darting options, I have had success by just packing ointment in the socket. I have also had a rhino with a gunshot wound that lost one eye heal well with no surgery. Another, that lost his eye from running through thick dry “sekelbos“, that we left to heal without surgery. Gary Bauer, [14 Mar 2025 at 17:29:01]: It's amazing what happens sometimes if we let nature take its course.... Erik Verrynne, [14 Mar 2025 at 17:29:48]: That’s the limitation. You need a follow up. Gary Bauer, [14 Mar 2025 at 17:30:17]: And no trunk Erik... Erik Verrynne, [14 Mar 2025 at 17:39:09]: True. Mark Lombard, [15 Mar 2025 at 06:46:00]: Thank you, Gary and Erik. This is a huge help. I will forward all this to the surgeon who is helping with the enucleation and post the technique and care we use. Many thanks again. Rob Jackson, [16 Mar 2025 at 11:43:51]: Calcium alginate pads might work to fill the dead space socket. This will initially provide back pressure against bleeding, then will form a gel that promotes healing. I have put these into wounds and bullet tracts on rhino. Johan Marais uses these under dehorning injury patches.
