What does the treatment involve?
Evisceration is a surgical technique that involves emptying the content of the eye. Part of the eye is extracted (the cornea, iris and retina) but the sclera (the outermost white layer of the eye) and the muscles that make the eye movements remain. It would be similar to conserving the shell of an egg and removing the yolk and the white.
Once we have emptied the eye content, we will put in an implant that gives volume to the orbit cavity in the same operation.
When is evisceration indicated?
- In blind, painful eyes, for non-tumoral causes. Patients who complain of pain that cannot be controlled with medication, that prevents them from going about their normal lives, and affects their mood, social relationships, etc.
- In cases of eyeballs that have lost their volume (phthisis) due to a trauma or disease, patients that cannot see and wish to improve their appearance.
- For blind eyes that are large (buphthalmos) due to congenital glaucoma, for example.
- In cases of intraocular infections (endophthalmitis) in which restoring vision is not possible.
In short, performing an evisceration in cases of blind, painful eyes, of different sizes, etc. is a technique that always gives very cosmetic good results.
Enucleation (removal of the whole eyeball) is only indicated in cases of a malignant intraocular tumour. We would never perform an evisceration on these patients.
How is an evisceration performed?
It is a surgical procedure that we perform in the surgical theatre under general anaesthesia. However, in isolated cases it can be performed with local anaesthesia and profound sedation.
With this technique, the ophthalmologist specialising in cosmetic eye surgery extracts the whole cornea and empties the content of the eyeball.
We perform some lateral incisions in the sclera so we can insert the internal implant (the most commonly used is made of porous polyethylene) of the size we need, regardless of how small the eyeball is. Thus, we get a very good volume. In this technique, the muscles remain in their place, so the cosmetic results are optimum.
After the surgical procedure, we put on a compression bandage, and the patient is admitted to hospital for a night. The patient will come to hospital for seven days for daily treatment and dressing. On the last day of treatment, we will send them to the prosthetist, who will fit the patient with a temporary external prosthesis.
Seven or eight days after the operation, the patient can go about their normal life, as the external prothesis gives the cosmetic appearance of a healthy eye. A month after operation, the prosthetist fits the patient with a permanent prothesis which is practically the same as their healthy eye, giving a very satisfactory result.
It is a simple surgical technique in the hands of a specialise.
We require postoperative medication combining antibiotics to prevent an infection, and anti-inflammatories and painkillers to combat the inflammation and manage the immediate postoperative pain. Cases of infection are very very uncommon.
Professionals who perform this treatment
Frequently asked questions
What treatment do I need with the prosthesis? Is it comfortable to wear?
The prosthesis should be removed once a month to clean it. You can lead an absolutely normal life with it, practice sport with it and it is not annoying or painful.
Aesthetically speaking, will people notice that it's not a "normal" eye?
In general, the result of surgery with an external prosthesis is magnificent. Prostheses are made with volume, and colour of the iris emulates the colour of the patient's healthy eye. As the muscles remain in place, the movement is also preserved so the patient will truly feel good with the result.