The surgery

I am a word person.  I have always loved discovering new words, which is the main reason why I enjoy learning other languages.  Occasionally a word comes along that makes me cringe, a word that I would put on my Least Favorite Words list.  Previously, rancid topped that list, and I will admit it still makes me cringe, but all the medical schooling I have received in the past year and (almost) a half has allowed me to put some more words on that list.  I think chemotherapy earns a spot, and certainly retinoblastoma, but the very top word now is enucleation.  That is the name of the surgery Anya just went through, and I have a very hard time saying it still, usually opting instead for removal of the eye.  Perhaps, though, with time I will become more accustomed to it as I have with chemo and rb - I am so used to those that they even have nicknames now.

Enucleation is the removal of the diseased eye.  The surgeon explained to us that it is quite a simple surgery to perform, in contrast to the scleral buckles Anya had put on both eyes just over a year ago.  After the eye was removed, the surgeon fit her eye with an implant.  The implant fills the socket and they attach the muscles to it in order to get as much future movement from it as possible, so it later looks like a real eye.  Anya's implant is made of coral and has holes in it, which allow the tissues to grow into it.  The implant that she received is 18 millimeters.  According to the surgeon, this is a "good size."  Time will tell if somewhere down the line she may need a larger implant.  That, of course, would mean another surgery.

After the implant is secured, they bring the conjunctiva around the implant and stitch it together.  The conjunctiva is the white tissue that is found on the inside of the eyelid.  Then, a conformer is placed which is like a huge contact lens.  It sits inside the eyelid and saves the space for the prosthetic eye that will come later.  The conformer also provides a barrier in between the eyelid and the stitches.  When Anya's eye has healed enough, the conformer will come out and be replaced with her prosthetic eye, which will be hand painted to look exactly like her other eye.  I was under the misconception that the prosthetic eye is spherical and she, or we, would have to remove the entire thing when it came time to clean it.  This is not true.  The spherical part is the implant which is now stitched behind the conjunctiva and will only come out if another surgery is needed.  The prosthesis, similar to the conformer, is really like a giant contact lens.

Her eye remains terribly swollen and bruised.  It continues to ooze, but the dried blood and ooze seem to be loosening up so she may be able to open her eye soon.  When she does, it should look pinkish, like the inside of the lip.  She continues to be pain free and doing nearly all the things she normally does, with the exception of biking and swimming.  Biking because she hasn't asked, and we aren't going to bring it up if she doesn't, and swimming because of the risk of infection.  She doesn't yet know it, but she won't be able to swim for months.