Unfortunately, sometimes the eye must be removed. Be it from trauma, malignancy, or an ocular disease that has rendered the eye blind and painful, making the decision is no small matter. Fortunately, Dr. Chen and Pharo are highly trained in removal of the eye and reconstruction of the orbit after removal with the goal of obtaining as good a result as possible. Below are some of the different techniques used to remove the eye and reconstruct the orbit.

Surgical Techniques for Removal

Ocular evisceration is a surgical procedure performed to remove the contents of the eye while preserving the outer shell, known as the scleral shell. During the procedure, the eye's internal contents, including the vitreous humor, lens, retina and uvea, are carefully removed while leaving the sclera intact. Following evisceration, an orbital implant is inserted into or behind the scleral shell to restore volume and provide support for a prosthetic eye. Ocular evisceration aims to alleviate pain, address infection or disease, and improve cosmesis for patients who have experienced irreparable damage to their eye.

Ocular enucleation is a surgical procedure performed to completely remove the entire eye, including the scleral shell and its internal contents. It is typically done in cases where the sclera is compromised or the eye is severely damaged due to trauma, intraocular tumors, or intractable infection that cannot be effectively managed by other means. The procedure involves detaching the eye muscles and optic nerve from the eye, removing the entire globe, and closing the eye socket with sutures. Following enucleation, an orbital implant may be placed to provide support and maintain the shape of the eye socket. Ocular enucleation can provide relief from pain, control disease progression, and enable the fitting and use of an ocular prosthesis to restore the appearance of the eye.

Orbital exenteration is an extensive surgical procedure performed in cases where there is advanced or invasive disease within the orbit that cannot be controlled by other means. It involves the removal of the entire contents of the orbit, including the eye, eyelids, surrounding soft tissues, and sometimes portions of the adjacent bones. Orbital exenteration is typically indicated for aggressive tumors, such as certain types of orbital cancers or extensive orbital infections that pose a significant risk to the patient's health. The procedure aims to eradicate the disease, prevent its spread, and preserve the patient's overall well-being. After orbital exenteration, the surgical defect may be reconstructed using various techniques, including the placement of a prosthesis, local flaps, or skin grafts. While orbital exenteration is a major surgery with profound functional and cosmetic implications, it can be a life-saving procedure for certain conditions that require aggressive intervention. Thankfully, this procedure is only required in rare circumstances.