Eye Removal Surgery

Eye Removal Surgery is performed to either surgically remove the entire eye or the contents of the eye, leaving the white part of the eye (the sclera) and the eye muscles intact. Eye Removal Surgery is done for eye cancer, painful blind eye or following a severe injury or infection of the eye.

Some facts about Eye Removal Surgery:

• Eye Removal Surgery may be required to control pain in a blind eye, to treat some intraocular tumors, to alleviate a severe infection inside the eye, or for cosmetic improvement of a disfigured eye following a severe injury.
• An ocularist should be chosen and an appointment with them should be scheduled before the surgery.
• It may take two months of healing before you can be fitted for a prosthesis.

Types of Eye Removal Surgery:

• Enucleation and Evisceration are two main types of eye removal surgery.
• The entire eye will be removed in an enucleation. The muscles that control eye movement will be left intact and will be resewn to the artificial eyeball.
• The cornea which is a clear, dome shaped window at the front of the eye and the contents of the eye will be removed, while the white part of the eye and the eye muscles are left intact.
• The implant is then attached to the scleral shell to which the muscles are still attached.
• Evisceration is generally takes less time and is less invasive than Enucleation.
• Enucleation is usually preferred over evisceration with cancer, trauma and infection of the eye.
• Enucleation is the preferred procedure if the eye is being removed to treat an intraocular tumor.
• The risk of developing a severe auto immune condition for your healthy eye called sympathetic ophthalmia following trauma can be reduced by Enucleation.
• The desired objective can be achieved by both the procedure in most of the cases.
• The most appropriate type of surgery for your condition will be determined by your surgeon.

Preparation for Eye Removal Surgery:

• A complete physical and eye examination will be done before Eye Removal surgery.
• Any prior treatments to fix your Eye Removal problems will be noted by your eye doctor.
• You will have to stop taking medications that can increase your risk of bleeding about seven to ten days before your surgery. These include aspirin, ibuprofen, naproxen sodium, warfarin, heparin and clopidogrel.
• You should inform your doctor about any other prescription drugs, over-the-counter medications, or supplements you may be taking.
• 8 to 10 hours of fasting is often required before the surgery to avoid adverse reactions to the anesthesia, like nausea and vomiting.
• Usually, general anesthetic will be given to the children who undergo Eye Removal surgery to puts them to sleep throughout the procedure and not to feel any pain.
• Generally, adults are treated with a local anesthetic that numbs the eye.

Procedure for Eye Removal Surgery:

• Usually both type of surgeries are performed in the operating room under local anesthesia with sedation or general anesthesia.
• Most of the lost volume is replaced by a spherically shaped implant or fatty tissue from the own body of the patient placed in the eye socket after enucleation or evisceration.
• A variety of materials including acrylic, hydroxyapatite, porous polyethyline, or dermis fat can be used for implants.
• The eye muscles are attached to the implant following enucleation in most cases to preserve eye movement.
• The implant may be wrapped with sclera from a cadaver to ease attaching muscles to the implant and to allow for a smooth surface interface with the own tissue of the patient that will cover the implant.
• A temporary plastic prosthetic called a conformer is placed over the implant which helps healing and serves as a placeholder between the eyelids and the orbital implant.
• The eyelid is closed to help the wound heal and hold the conformer in place.
• A large pressure bandage or dressing is placed over the eye to protect the wound, prevent bleeding and help reduce inflammation such as swelling, soreness, and bruising.
• You can go home the same day after both type of surgery as it is outpatient and take about an hour.

Recovery from Eye Removal Surgery:

• Medications such as antibiotics, steroids, or pain relievers are prescribed after surgery.
• You may have to wear a patch after surgery for several days to several weeks, until you receive your prosthesis.
• An artificial eye, or prosthesis, is made by an ocularist several weeks after surgery which is a very large, thick, and firm contact lens.
• The front surface of the artificial eye is custom painted to match the other eye of the patient and the back surface is custom molded to fit exactly in the eye socket for providing maximum comfort and movement.
• The prosthesis can be removed as needed for cleaning as it is easily removable.
• You should follow up with the ocularist and surgeon every 6 to 12 months to ensure that the socket is healthy as the socket may atrophy (shrink) with time.
• Eyelid laxity or socket changes that may affect the fit of the prosthesis may result from this loss of volume.
• The prosthesis can also irritate tissues on the back of the eyelid or the tissues on the surface of the implant. So, these changes should be monitored
• Your prosthesis can last longer if properly cleaned and maintained.
• Swimming, strenuous exercise or other physical activities are restricted for two to four weeks after the surgery.
• Lifting heaving objects and bending at the waist should also be avoided for up to one month after surgery.
• The bandage that is covering the eye should be kept dry.

Risks and Complications of Eye Removal Surgery:

• Bleeding and infection are the most common potential risks associated with Eye Removal Surgery which can be avoided by stopping blood thinners before the surgery.
• Discharge and socket irritation or exposure of the implant are some of the longer-range complications