What is Evisceration?
Evisceration surgery refers to the removal of the inside contents of the eye (cornea, iris, lens, vitreous, and retina). The white shell of the eye (sclera) is left in place. The extraocular muscles are left attached to the eye surface and the optic nerve is not cut. Once the contents of the eye are removed, an implant is placed into the scleral shell. The sclera, Tenons, and conjunctiva are then closed over the implant and a temporary (clear plastic) conformer is put in place. The real artificial eye (prosthesis) is made in about 6-8 weeks.
Evisceration is quicker and simpler to do than enucleation. There is less anatomical disruption to the eye socket with evisceration and the end results (appearance, movement) are better. However, there are some situations where one simply cannot have an evisceration. In any eye that has a tumor (e.g., melanoma) or suspected tumor, an enucleation is the only option. If the diseased eye has end stage glaucoma, end stage diabetes, is a post trauma eye, has a known history without suspicion of a tumor, an evisceration is suitable and becoming increasingly common because of the ease of surgery and the excellent cosmetic results.
Evisceration can be done under local stand-by (twilight anaesthesia) or general anaesthesia and is performed as an outpatient visit. The pain is variable and dependant upon one’s pain threshold. Generally, there is some pain but usually it is not severe. It settles in the first 3 to 5 days.