An oculoplastic surgeon performing an
Enucleation of the eye procedure.
Removal of the eye by enucleation or
evisceration can relieve pain and minimize further risk to life and well-being
of an individual with the above noted conditions. In addition, procedures to
remove the eye should address the resultant appearance of the orbit. Orbital
implants and ocular prostheses are used by the surgeon to restore a more
natural appearance.
An orbital implant is placed after
removal of the eye to restore volume to the eye socket and enhance movement or
motility of an ocular prosthesis and eyelids. The eyeball is a slightly
elongated sphere with a diameter of approximately 24 millimetres. To avoid a
sunken appearance to the eye socket, an implant approximating this volume can
be placed into the space of the removed eye, secured, and covered with Tenon's capsule and conjunctiva (the
mucous membrane covering the natural sclera). Implants can be made of many
materials with the most common being plastic,hydroxylapatite, metal alloy or glass.
Later, once the conjunctiva have
healed and post-operative swelling has subsided, an ocular prosthesis can be placed to provide
the appearance of a natural eye. The prosthesis is fabricated by an ocularist. Its form is that of a cupped disc so that it can
fit comfortably in the pocket behind the eyelids overlying the conjunctiva that
covers the orbital implant. The external portion of the ocular prosthesis is
painted and finished to mimic a natural eye color, shape and luster. It can be
removed and cleaned periodically by the individual or a care giver.
The two part system of orbital implant and ocular
prosthesis provides a stable, and well tolerated aesthetic restoration of the
eye socket. Although vision is not restored by removal of the eye with
placement of an orbital implant and ocular prosthesis, a natural appearance can
result. The implant can be moved by intact extraocular muscles that will track
or move simultaneously with the other eye. The visible ocular prosthesis can
couple with the orbital implant and thus move simultaneously with the other
eye. The eyelids can move and blink over the prosthesis as well.