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Enucleation is a surgical procedure where the entire eyeball is removed from the eye socket. It is commonly used to treat intraocular tumors, severe inflammation, and uncontrolled pain. An artificial eye prosthesis is used for cosmetic improvement. Ocular tumors requiring enucleation include retinoblastomas and ocular melanomas. Sympathetic ophthalmia is another rare condition that requires eye removal. General anesthesia is preferred, and an orbital implant is used to fill the space in the orbit. Artificial eyes can last several decades, and newer designs of orbital implants produce a more natural look.
In medicine, enucleation refers to a surgical procedure in which a surgeon removes the entire eyeball from the eye socket or socket. One of the three possible procedures for eye removal, enucleation is the procedure of choice for intraocular tumors. Other common reasons for enucleation include unrecoverable eye trauma, severe inflammation, and uncontrolled pain in one eye. Ophthalmologists perform enucleations as a last resort in situations where the condition being treated cannot be adequately managed otherwise. Most patients undergoing enucleation get an artificial eye prosthesis to replace the extracted eye for cosmetic improvement.
The two most common ocular tumors requiring enucleation are retinoblastomas and ocular melanomas. Retinoblastomas are malignant tumors of the retina. Ocular melanomas can affect the colored part of the eye, the iris, or the vascular lining of the eye, the choroid. Melanomas arise from abnormal pigmented cells, or melanocytes. When tumors are very large and there is no useful viewing perspective, enucleation is performed to prevent local and distant spread of tumors.
Another rare condition that requires removal of an eye is sympathetic ophthalmia. This is inflammation of both eyes resulting from massive trauma to one eye. The body begins to mount an immune attack against the eye tissue in both eyes. The only way to treat the condition and spare the good eye is to remove the injured eye.
General anesthesia, in which the patient is completely unconscious, is the preferred anesthesia for an enucleation. The surgeon dissects the orbital tissues, including the eye muscles, away from the eye. The optic nerve is severed approximately one centimeter (0.45 inch) from the back of the eye. Once the eye is extracted, an orbital implant, made of hydroxyapatite or silicone rubber, fills the space in the orbit with the patient’s soft orbital tissues covering it. To allow for some movement of the artificial eye, the surgeon attaches eye muscles to the implant.
Once the patient has recovered from an enucleation, they can get an eye prosthesis. An ocularist is a technician who specializes in the design and customization of artificial eyes. He shapes the posterior surface of the prosthesis precisely to fit the patient’s orbit. The prostheses can be painted to exactly match the patient’s other eye. Artificial eyes can last several decades.
Older designs of orbital implants, typically made of plastic, don’t move in concert with the other eye. Advances in implants use porous material, which allows blood vessels and fibrous tissue to grow into the implant. The attached eye muscles move the overlying custom made artificial eyes and implants. This produces a more natural look for the patient.
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