Restore comfort, appearance, and function after severe eye trauma, tumors, or painful blindness with expert eye removal surgery. David Isaacs, MD, our expert dual-fellowship trained oculofacial plastic surgeon, specializes in enucleation and evisceration to treat intraocular tumors, congenital abnormalities, infection, and more. His approach ensures the best foundation for long-term success with prosthetic eyes.
Relieve Pain and Prepare
for Prosthetic Eyes
Eye removal surgery may be necessary when the eye becomes blind, painful, severely damaged, or affected by a condition that threatens surrounding tissues. Common indications include trauma, intraocular tumors, severe infections, congenital abnormalities, or complications from prior surgeries. In some cases, the affected eye not only causes discomfort but may also lead to disfigurement or pose a risk to the health of the other eye.
There are two primary types of eye removal procedures: enucleation and evisceration. Enucleation involves removing the entire eyeball while preserving the surrounding orbital structures. This is often preferred when tumors or extensive trauma are present. Evisceration, on the other hand, removes the contents of the eye but retains the outer scleral shell, often allowing for more natural prosthetic movement. Both procedures typically involve placing an orbital implant to restore volume and prepare the socket for a prosthetic eye.
Indications for Eye Removal (Enucleation & Evisceration):
- Severe trauma resulting in a non-functional eye
- Painful blind eye unresponsive to treatment
- Intraocular tumors requiring complete removal
- Infections that threaten surrounding structures
- Congenital eye abnormalities with no visual potential
- Complications from failed prior eye surgeries
Correcting Upper Sulcus Deformity
and Volume Loss
If you’ve had an eye removed, you may notice a hollow or sunken appearance in the upper eyelid. This is known as upper sulcus deformity, and it typically results from orbital volume loss, soft tissue atrophy, or a poorly sized or positioned implant. While enucleation and evisceration generally involve the placement of an orbital implant to restore volume and support a prosthetic eye, additional interventions are often necessary to fully correct upper sulcus hollowing.
Dr. Isaacs offers several highly effective options to restore symmetry and fullness:
- Implant Replacement: If your current implant is undersized or improperly placed, it can be exchanged for a better-fitting one to improve upper eyelid contour and prosthetic fit.
- Implant Placement: For patients without a prior implant or with significant volume loss, inserting a new orbital implant can restore natural fullness.
- Upper Sulcus Volume Augmentation: Dr. Isaacs may use fat grafting or dermal fillers to smooth the hollow area above your prosthetic eye.
Revision Surgery for Poorly Fitting
Prosthetic Eyes
If your prosthetic eye feels uncomfortable, looks unnatural, or doesn’t stay in place, revision surgery may be the solution. After eye removal, it’s common to experience complications like socket contraction, volume loss, or implant instability. These issues can lead to poor prosthetic fit, eyelid retraction, or even visible implant exposure.
Dr. Isaacs specializes in advanced socket reconstruction and volume restoration, including:
- Dermis Fat Grafting (DFG): Using a graft from your own body, this technique restores lost volume, corrects socket contraction, and improves stability.
- Implant Replacement or Removal: If your current implant is exposed, infected, or causing pain, Dr. Isaacs can safely remove and replace it with a better-sized, more stable option.
- Eyelid and Socket Reconstruction: Techniques such as lower eyelid tightening and upper sulcus augmentation help improve prosthetic retention and restore a natural appearance.
- Botulinum Toxin Injections: In select cases, Dr. Isaacs uses botulinum toxin to fine-tune eyelid contour and enhance prosthetic fit, an innovative method few surgeons offer.
Dr. Isaacs Collaborates Closely With Ocularists
To ensure the best possible outcome, Dr. Isaacs works hand-in-hand with expert ocularists to provide you with a custom-fitted prosthetic eye that looks and feels natural. Your prosthesis will be carefully crafted to match your remaining eye in size, color, and movement. This close collaboration begins even before surgery, with precision measurements to guide implant placement and socket reconstruction. After surgery, your ocularist will fine-tune the prosthesis to ensure an optimal fit and comfort based on your healing and anatomy. This approach allows for long-term success and a natural, balanced appearance.
Schedule Your Consultation
David Isaacs, MD, is a dual-fellowship trained oculofacial plastic and orbital surgeon specializing in complex anophthalmic socket reconstruction, enucleation, and evisceration. Known for his meticulous techniques, Dr. Isaacs uses advanced surgical methods to restore comfort, function, and appearance with minimal visible scarring. If you need eye removal or revision surgery, schedule your private consultation in Beverly Hills today.
