What is ocular evisceration?
Evisceration is a surgical intervention in which different parts of the eye are removed –more specifically the cornea, and all the internal parts of the eyeball– and the sclerotica (the white part of the eye) and the surrounding muscles that position and move the eye are left intact. In other words, we only remove the contents of the eye, preserving the external structures. We then insert a spherical implant to prevent the eye socket from remaining empty and without volume.
This is a more conservative operation than enucleation, in which the entire eyeball is removed. It is therefore often simpler and involves less time in surgery.
Problems treated with ocular evisceration
Ocular evisceration is basically recommended in the following cases:
- Blind eyes causing recurrent or persistent pain: when this happens, the goal of evisceration is to remove the pain and improve the quality of life.
- Phthisis bulbi: this ophthalmological disorder is an atrophy of the eyeball that leads to its loss of volume and functionality (little or no vision). It is often the result of severe eye disease, an irreversible complication from ophthalmological surgery, or a severe eye injury. In this case, the surgery is performed to improve the appearance of the face.
- Buphthalmos: this abnormality, also know as hydrophthalmia, is a disease that is characterised by the distension (increase in size) and hardening of the eyeball due to an excessive secretion of aqueous humour, which in turn leads to an increase in intraocular pressure. In fact, buphthalmos is classed as a severe form of glaucoma. Like in the other case, ocular evisceration is used to balance the face.
- Serious eye infections: some eye infections such as endophthalmitis or panophthalmitis can lead to evisceration of the eye if not treated in time or if they do not respond to antibiotic therapy.
As a general rule, eye tumours or patients whose sclera is greatly damaged are not candidates for evisceration, and enucleation of the eye is considered in these cases.
Ocular evisceration surgery is performed in outpatients, so you can go home by yourself on the same day as the surgery, after a few hours in observation. On leaving the operating theatre, you will be given instructions from your specialist to apply antibiotic and anti-inflammatory drops to speed up the healing process of the eye and to avoid post-surgical infection. As with other ophthalmological operations, you should not push yourself too much over the first few weeks, carry too much weight, or move your head suddenly. However, you can generally return to your everyday activities.
One month after the ocular evisceration, your surgeon will check your progress and will fit a prosthesis over the implant to imitate the appearance of the healthy eye. This implant does not have to be replaced over time, except in exceptional cases, and it has a certain range of movement thanks to the preserved muscle.
Noticing the area of the eye inflamed, bruised and with discomfort after surgery, as well as difficulties opening your eye, are all part of the usual process. Do not be alarmed if you have headaches or even sickness, or if you bleed slightly. However, if you notice a lot of blood or you experience growing pain that does not respond to treatment, you must consult your ophthalmologist to assess the appearance of possible complications, such as haemorrhage or inflammation.
The Miranza specialists are available to support you throughout the post-operative process, and to monitor your progress and solve any doubts you might have.