Injuries, disease causing total vision loss and pain and infections are some of the reasons why eyes are removed. Glaucoma is one of the top reasons for vision loss that results in the eye being removed. But doctors will not perform this procedure until all other treatments have been tried unsuccessfully.
There are three types of eye removal.
Evisceration is a surgical procedure in which the inner contents of the eye are removed, including the iris, and cornea and leaving behind the sclera with the extra ocular muscles still attached. This is so that an orbital implant can be placed inside the sclera to replace the lost eye. After healing takes place, typically six to eight weeks, a sclera shell is fit for the patient.
Enucleation is removal of the eyeball, leaving the remaining orbital contents intact. The extra ocular muscles are detached and reattached to an orbital implant or fat graft. An artificial eye is then put in after healing takes place.
Exenteration is removal of the contents of the eye socket including the eyeball, fat, muscles and other adjacent structures of the eye. The eyelids may also be removed n cases of cancer or infection. A maxillofacial prosthesis is recommended after surgery.
Orbital implants are used after surgery in the evisceration and enucleation procedures to remover some of the volume lost in the procedures. The orbital implant is attached to the four rectos muscles and provides movement of the implant with the fellow eye. This is a very important part of the procedure. If the implant is properly attached to the muscles, it will provide optimal movement of the artificial eye or scleral shell.
The surgeon responsible for the surgery determines the procedure that is used. The orbital implant is always put in at the time of the surgery. The tissue around the implant must heal completely before the artificial eye can be created and inserted.
The procedure to create the artificial eye is impressive. First wax is inserted to make an impression of the underlying tissue. This is used to create the actual eye, which is then painted to match the patient’s other eye.
Once this is done, the eye can be slipped in and out as easily as a contact lens, although it is thicker and bigger than a contact lens. It can move in conjunction with the other eye, both side to side and up and down, just like two healthy eyes move together. See the websites below for actual pictures and more details.
http://www.evisceration.info/
