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from Section 23 - Ophthalmic Surgery
Published online by Cambridge University Press: 05 September 2013
Removal of an eye or the contents of an orbit may be indicated when the eye is affected by neoplasia or a severe infectious process, or when an end-stage ocular disease in a blind eye causes pain. These ophthalmic interventions are usually classified as:
Enucleation: the removal of the entire globe, including the sclera, intraocular contents, and the cornea. The stump of the optic nerve as well as the extraocular muscles are left behind.
Evisceration: the removal of intraocular contents including the lens, uvea, retina, vitreous humor, and in some cases the cornea. Only the sclera and extraocular muscles remain intact.
Exenteration: the removal of the globe and all of the orbital contents. This procedure may include removal of selective sections of orbital bone.
Following enucleations and eviscerations, an orbital implant is used to replace the globe and restore the lost orbital volume. The implant or sphere serves to maintain the structure of the orbit and to provide motility to the overlying prosthesis. For children, it additionally serves to maintain more normal growth of the surrounding orbital bones. In cases of exenteration, an osseointegrated prosthesis may be attached within the orbit, secured with metal support elements or magnets that are attached to bone.
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