There are three types of eye removal performed at Idaho Eyelid and Facial Plastic Surgery: evisceration, enucleation, and exenteration. The differences among these types of eye removal are explained below. Orbital implants and ocular prostheses are used by the surgeon to improve cosmesis, which is the preservation, restoration or enhancement of physical appearance.
Evisceration is the removal of the internal eye contents (iris, lens, vitreous, retina, and choroid), but the sclera is left behind with the extraocular muscles still attached. Either general or local anesthetics may possibly be used during eviscerations, with antibiotics and anti-inflammatory agents injected intravenously. An ocular prosthetic can be fit over the eviscerated eye in order to restore a more natural appearance. There is improved motility because the muscles that control eye movement remain attached to the sclera. The sphere may possibly be made of MEDPOR®, PMMA, hydroxyapatite or other material, and this orbital sphere/implant remains permanently. A prosthetic eye can be made 6-8 weeks later by an ocularist who works with Idaho Eyelid and Facial Plastic Surgery.
Enucleation is removal of the eyeball, but the adjacent structures of the eye socket and eyelids remain. An intraocular tumor excision requires an enucleation., not an evisceration. This type of ocular surgery is indicated for a number of different ocular tumors when eyes that have suffered severe trauma, and in eyes that are blind and painful due to other disease. The entire eye (iris, lens, vitreous, retina, and choroid) and sclera are removed. Muscles are detached from the sclera and may possibly be re-attached to the implant. The implant may possibly be made of MEDPOR®, PMMA, hydroxyapatite or other material, or may possibly be a dermis-fat graft. The orbital sphere or implant remains permanently and a prosthetic eye can be made 6-8 weeks later by an ocularist.
Note: auto-enucleation. (oedipism) and other forms of serious self-inflicted eye injury are an extremely rare form of severe self-harm which usually results from serious mental illnesses such as schizophrenia. The name comes from Oedipus, who gouged out his eyes in penance after having sex with his mother and killing his father.
Exenteration is the removal of the contents of the eye socket (orbit) including the eyeball, fat, muscles and other adjacent structures of the eye. The eyelids may also be removed in cases of cutaneous cancers and unrelenting infection. Exenteration may be done together with maxillectomy which is removal of the maxilla or the upper jaw bone/cheekbone. Since the orbit is empty after exenteration, implants are more difficult to create. Some may possibly be attached to eyeglasses, others to the orbit with the help of magnets. Note there is no soft tissue within the orbit.