Enucleation

Enucleation is usually performed for several different reasons: to remove a malignant tumor such as ocular skin cancer that has developed within the eye; to alleviate intolerable pain in a blind eye affected by a condition such as uncontrollable glaucoma; or to reduce the risk of “sympathetic” inflammation of the remaining eye when one eye has been severely injured and blinded.

Removal of an eye is considered a drastic and traumatic measure to most people. Although many patients who require this surgery have no vision in the affected eye, those who do have vision recognize that enucleation will result in instantaneous, permanent, total blindness of that eye. Furthermore, all patients who undergo this procedure will require an artificial eye (ocular prosthesis) as a cosmetic substitute for the real eye. In some cases, patients may have previously undergone evisceration or similar ocular surgeries before considering enucleation.

Enucleation is usually performed under general anesthesia, immediately after the eyeball has been removed. An orbital implant, only slightly smaller than the eye, is inserted deep in the socket. Muscles are attached to the implant to improve motility. The implant is covered externally with conjunctiva, the pink surface tissue that lines the eyelids and is similar to the inner lining of the mouth.