Evacuation of the eye contents was defined as evisceration, and removal of the eyeball is defined as enucleation.

Evisceration / Evacuation of the Eye

Patients with evisceration indication are blind and have no possibility of seeing, and most of them have perforating (penetrating eye injury) injuries. Some of these patients have pain due to uncontrollable intraocular pressure in their blind eyes. Some of them
are patients who have pain due to their shrinking (phthisis bulbi) eyeball. Patients who lost their vision due to glaucoma are also included in this group.

How Is the Intraocular Emptying?

Evisceration surgery should be perfomed under general anesthesia. After the cornea is removed in the surgery, the uveal tissues are cleaned and a sphere (socket) is placed in the scleral cavity. Thus, the patient is relieved of pain and becomes able to wear a prosthetic eye. 

Image-1: Evisceration

The operation takes 60-75 minutes. Full recovery takes about 2-3 months. It is necessary to wait 3 months for the prosthesis to be placed.

Eye Removal / Enucleation

Enucleation is the complete removal of the eyeball. Enucleation is often done due to intraocular tumors. It is aimed not to spread the tumor. It is important to protect the eye muscles in this process. After the enucleation, a material called a socket should be put in place of the eyeball that is removed. Eye muscles should also be sutured to this socket. If this is not done, the prosthetic eye that will be used later will remain motionless. 

Image-2: Enucleation

The operation takes 90-120 minutes under general anesthesia. Full recovery can be achieved in approximately 2-3 months. Rarely, in the future, it may cause a perception as if the eye has shrunk due to socket withdrawal (socket contraction). In some cases, a skin-fat tissue (dermofat graft) can be placed instead of the socket.

What Should Physician Preference Be in Emptying or Removing the Eye?

Evisceration and Enucleation are both specialty surgeries. It is a condition that directly affects the prosthetic eye use process. It is very important that the pre-surgical procedures are successful in order not to experience any difficulties in this process. For this reason, I think that choosing the an oculoplastic surgeon, would be beneficial.