SERVICES: Artificial Eye Implants
Overview:
There are many paths leading to placement of an artificial eye, and each patient’s journey is unique. Some patients experience a devastating injury to an eye requiring surgery. Others have had multiple surgeries on their eye and find themselves in pain without useful vision. Still others learn they have a cancer within an eye that requires removing the eye to treat the cancer.
Regardless of the road leading to surgery, many patients find themselves overwhelmed as they prepare for surgery to remove an eye. Our goal is to provide patients a resource to learn about the surgery and help give them the knowledge they need to navigate a difficult time.
My doctor referred me to Dr. Repp for placement of an artificial eye. I’m preparing to meet with Dr. Repp, but I would like to know a little bit about the surgery before our meeting.
What should I know about the surgery before I visit Dr. Repp?
It may help to have a broad overview. Surgery to remove an eye is typically an outpatient, or day surgery. Most patients will return home the day of surgery to start their recovery. The surgery is often performed in an ambulatory surgery center.
During surgery an anesthesiologist will care for your general comfort, often administering IV sedation. Your anesthesiologist will work directly with you to customize a plan for your overall comfort during surgery.
Once your general comfort is assured, Dr. Repp will proceed with surgery to remove the eye and place an implant into the eye socket. The implant is shaped like a round ball and placed deep into the eye socket and then completely covered with the normal mucous membrane that lines the eyelids. The implant plays the important role of maintaining the order and volume of the eye socket. Most of the time the implant is never seen by a patient, because generally, it remains buried behind the mucous membranes of the eye socket.
At the end of the surgery, Dr. Repp will place a “conformer” on top of the mucous membranes of the eye socket and behind the eyelids. You can think of a conformer much like a large, thick contact lens. The conformer stays in place while you recover, acting as a “splint” to help the eyelids and eye socket heal appropriately. The conformer stays in place for about six weeks, at which point it is replaced with a prosthesis (see below).
After surgery, most patients will return home the same day for recovery.
Are there any common symptoms following surgery?
Patients may experience pain or upset stomach following surgery. Dr. Repp will discuss this with you when you first meet to help tailor a treatment plan to keep you comfortable as you recover.
What is the difference between an enucleation and an evisceration?
You may come across these terms as you read about surgery to remove an eye. Enucleation is removal of the entire eye, including its tough outer wall called the “sclera.” This is the only option for patients that need treatment for cancer within the eye. Evisceration, on the other hand, is a surgery that spares the outer wall of the eye, removing the internal contents only. Evisceration is not an option to treat patients with a cancer within the eye, but evisceration is an option for other conditions requiring removal of the eye. Both surgeries are generally successful – Dr. Repp can counsel you further as to whether you may benefit from one surgery over the other.
Where does the implant go, and what is a “prosthesis?”
One of the most confusing terms regarding surgery to remove an eye is the term “implant.” An implant is a round, ball-like object that helps maintain the structure of the eye socket, keeping the order of the eye socket intact after surgery. The implant is placed behind the mucous membranes of the eye socket, where it generally remains permanently hidden from view. Many patients often think of a “glass eye” when they hear the term “implant,” but this is not the case because most of the time the implant is buried deep in the eye socket. The closest thing to a “glass eye” is a prosthesis, because a prosthesis is visible. The prosthesis is shaped like a thin shell.
After the eye socket has a chance to fully heal from surgery, the prosthesis is placed. The prosthesis is the visible shell seen from the outside that is painted to resemble an eye. The prosthesis rides over the mucous membranes of the eye socket and behind the eyelids, mimicking your other eye.
What role does an ocularist play?
Approximately six weeks following surgery, Dr. Repp will refer you to an ocularist. The ocularist specializes in crafting your prosthesis. Your ocularist will make a custom prosthesis that fits your eye socket comfortably like a glove while also giving the prosthesis the appearance of a normal eye.
Is there anything else I should know?
Many patients describe losing an eye as one of the most difficult emotional events they have experienced. Many face powerful feelings of grief and loss similar to the loss of a loved one. These emotions are common and normal. But please let Dr. Repp and his team know if you are struggling with these feelings, because you may need help during this difficult time. You do not have to navigate it alone.