Enucleation, Evisceration & Ball Implantation

What is enucleation and evisceration?

Evisceration is the surgical removal of the contents of the eye, leaving the white “shell” of the eye and the eye muscles intact. Enucleation involves removal of the entire globe and the attached eye muscles.

Do I require enucleation or evisceration?

There are several reasons why an eye or its contents are removed, for example to treat a painful blind eye, to treat certain eye tumors or severe eye injuries and to alleviate a severe infection inside the eye. Your ophthalmologist will help you decide which surgery is most appropriate for you, and the eye is only removed if all other suitable treatments have been tried and have failed.

What will my eye look like in the long term after enucleation or evisceration?

Once the eye socket has healed, about 6-8 weeks after your surgery, an artificial eye (prosthesis) will be made by an ocular prosthetist. The front surface of the artificial eye is custom painted to match the other eye. The back surface is molded to fit the socket for comfort and movement. Additional connections can be made at a later date to provide greater movement of the prosthesis. This procedure carries its own set of risks and should be discussed with your surgeon.

What does enucleation or evisceration surgery involve?

Both surgeries are usually performed in the operating room under general anaesthetic. They may also be safely performed using local anaesthetic with sedation, this option can be discussed with your anaesthetist and surgeon prior to surgery. The operation takes about one and a half hours.

You may be able to have the surgery as a day patient and go home the same day or it may be desirable for you to stay in overnight especially if you live alone or if you have a long journey home. Your doctor will discuss which will suit you best at your consultation. It is advisable to be driven home by a friend or relative and not to travel home on public transport. You must not drive yourself.

After enucleation or evisceration, an implant is usually placed in the eye socket to replace some of the volume lost. This implant is a sphere made of heat treated ocean coral, aluminum oxide, silicone or plastic. This implant will be covered by your own eye socket lining (conjunctiva), giving a pink appearance.