At times, it becomes necessary to surgically remove an eye that had become severely damaged by disease or injury.
There are two surgical procedures: enucleation and evisceration.
Enucleation is the surgical removal of the entire eye. Evisceration is the surgical removal of the contents of the eye, leaving the white part of the eye and the eye muscles intact.
Removal of an eye may be required to:
- control pain in a blind eye
- treat some intraocular tumours
- alleviate a severe infection inside the eye
- achieve cosmetic improvement of a disfigured eye
Enucleation is the procedure of choice if the eye is being removed to treat an intraocular tumour, or to try to reduce the risk of developing a severe auto-immune condition called sympathetic ophthalmia, following trauma. In most other situations, either enucleation or evisceration can each achieve the desired objective. The experts at Toronto Eyelid Surgery will help you to determine which surgery is most appropriate for your condition.
Both surgeries are usually performed in the operating room under general anaesthesia.
After enucleation or evisceration, most of the lost volume is replaced by an implant placed in the eye socket (read about artificial eyes that move naturally). The implant is usually a sphere made of silicone rubber, polyethylene, hydroxyapatite, medpore or alumina, and is covered by the patient’s own tissue. In most cases, the eye muscles are attached to the implant in order to preserve eye movement.
Six weeks after surgery, an artificial eye, or prosthesis, is made by an ocularist. The front surface of the artificial eye is custom painted to match the patient’s other eye. The back surface is custom molded to fit exactly in the eye socket for maximum comfort and movement. The prosthesis is easily removable, and may be removed as needed for cleaning. Most patients sleep with the prosthesis in place. A prosthesis is changed (via a moulding procedure) after five years.
Most patients spend the night at the hospital, while others go home the same day as surgery. You may be asked to take medications after surgery such as antibiotics, and pain relievers. Patients may wear a patch after surgery for several days to several weeks, until they receive their prosthesis.
Short-term risks for this surgery, as with any surgery, include bleeding and infection. Longer-range complications include discharge and socket irritation or exposure of the implant. As with any medical procedure, there may be other inherent risks that should be discussed with Dr. Maleki or Dr. Oestreicher.
Toronto Eyelid Surgery’s Dr. Oestreicher has published the world’s largest series of papers on patients with vascularizing orbital implants, which allow placement of the peg in a manner that maximizes natural movement.
