Surgical Techniques

There are three types of eye removal and several different options for implant. Orbital implants and ocular prostheses are used by {the} surgeon to restore a more natural appearance.

Evisceration

  • Removal of {the} internal eye contents, but {the} sclera is left behind with {the} extraocular muscles still attached. Either generalor local anesthetics may possibly be used during eviscerations, with antibiotics and anti-inflammatory agents injected intravenously

    An ocular prosthetic can be fit over {the} eviscerated eye in order to improve cosmesis.

    • Only {the} contents of {the} eye (iris, lens, vitreous, retina, and choroid) are removed
    • The leaves behind a pocket of sclera.
    • Improved motility: because {the} muscles that control eye movement remain attached to {the} sclera
    • Sclera is filled with an orbital implant or sphere.
    • The sphere may possibly be made of MEDPOR®, PMMA or hydroxyapatite material.
    • This orbital sphere or implant remains permanently
    • A prosthetic eye can be made 6-8 weeks later by an ocularist
    • Contrast with ENUCLEATION 

Enucleation

  • removal of {the} eyeball, but {the} adjacent structures of {the} eye socket and eyelids remain. An intraocular tumor excision requires an enucleation, not an evisceration
  • Enucleation is removal of {the} eye, leaving {the} eye muscles and remaining orbital contents intact.
  • This type of ocular surgery is indicated for a number of different ocular tumors, in eyes that have suffered severe trauma, and in eyes that are blind and painful due to other disease.
  • Auto-enucleation (oedipism) and other forms of serious self inflicted eye injury are an extremely rare form of severe self-harm which usually results from serious mental illnesses such as schizophrenia  The name comes from Oedipus, who gouged out his eyes in penance after having sex with his mother and killing his father
  • Details
  • The entire eye (iris, lens, vitreous, retina, and choroid) AND SCLERA are removed
  • Muscles are detached from {the} sclera and may possibly be re-attached to {the} implant
  • The implant may possibly be made of MEDPOR®, PMMA or hydroxyapatite material, or may possibly be a dermis fat graft
  • This orbital sphere or implant remains permanently
  • A prosthetic eye can be made 6-8 weeks later by an ocularist
  • contrast with evisceration

 

Exenteration 

  • removal of {the} contents of {the} eye socket (orbit) including {the} eyeball, fat, muscles and other adjacent structures of {the} eye.
  • The eyelids may possibly also be removed in cases of cutaneous cancers and unrelenting infection.
  • Exenteration is often done together with Maxillectomy which is removal of {the} maxilla or {the} upper jaw bone/cheekbone
  • An exenteration removes {the} entire ORBITAL contents, {the} eye, {the} muscles which control eye movement, and generally {the} eyelids.
  • Since {the} orbit is empty, implants are more difficult to create some may possibly be attached to eyeglasses, others to {the} orbit with {the} help of magnets
  • Note there is no soft tissue within {the} orbit. 

 

 
Procedures
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