Eye Removal

During an enucleation, the entire eyeball is removed. The conjunctiva covering the eye, the eye muscles, the lacrimal gland, the fat in the eye socket, and part of the optic nerve are spared in this procedure. The eyeball is removed by making an incision in the conjunctiva, detaching the eye muscles from the eyeball, and cutting through the optic nerve.

The eyeball is located in a cavity called the orbit. After the eyeball is removed, the resulting space must be filled immediately by inserting an implant. This is a small plastic sphere covered with donor sclera. The eye muscles, which move the eye, are then reattached to it. This secures the implant in the correct position and allows it to move. The connective tissue and mucous membrane are then sutured over the implant. An ocular prosthesis can then be placed over this.

During an evisceration, only the diseased part of the eye and the cornea are removed. The white part of the eye (the sclera) remains in the eye socket. The optic nerves and eye muscles are attached to it.

During the surgery, an implant is placed in the scleral space. The anterior scleral flap is then carefully sutured, after which the conjunctiva and mucosa are sutured over it.

In very rare cases, the eye socket itself is also removed. This is called an exenteration. This surgery is sometimes necessary in cases of an extensive malignant tumor in the eye socket or following a very serious accident. In some cases, doctors are able to preserve part of the skin of the eyelid.