Eye Removal Surgery - Enucleation and Evisceration

Sometimes it is necessary to have an eye removed surgically.  This necessarily can happen as a result of an injury, disfigurement or pain from a blind or poorly seeing eye, infection, or tumor.   An enucleation is a surgical procedure that removes the entire eye, while an evisceration removes the inner contents of the eye while preserving the sclera (white coating) of the eye.  There are indications for each procedure, and which procedure is necessary or recommended varies by case.  In either procedure, an effort is made to preserve any other healthy components of the eye socket, including the muscles that normally move the eye, eye socket fat, blood vessels, and a number of other tissue types.  

Enucleation and evisceration are both outpatient surgeries that are performed using local anesthesia as well as sedation or general anesthesia.  One of the main goals during these surgeries is to replace the lost volume from the removal of the eye.  This goal is typically accomplished by placing a spherical implant into the tissues of the eye socket, and then by having the residual tissues sewn in place over this implant.  This procedure allows increased comfort after the surgery as well as improvement of the cosmetic outcome of the procedure.  When the tissues have healed after surgery, patients can then be fitted with an ocular prosthesis that is created to mirror the appearance of the other eye.  An ocular prosthesis is typically not spherical, but rather it appears more like a large, thick, and firm contact lens.  This prosthesis rests between the eyelids and the eye socket tissues and is custom-fit for maximal comfort and movement.  This ocular prosthesis is created by an ocularist who specializes in the manufacture of artificial eyes.