During an enucleation, the patient is typically placed under general anesthesia (completely asleep) and the entire eyeball (the globe) is removed. Usually, an implant is placed in the socket under the soft tissues and attached to the eye muscles to fill up the space left from the removed eye. With an evisceration, the white part of the eye (sclera) with its attached muscles is left alone. Only the inside degenerated part is removed. The implant is then placed inside the sclera and closed up under the soft tissue. The goal of surgery is to eliminate the tumor or pain and leave the patient with a good cosmetic outcome.
After eye removal surgery a temporary shell is placed over the soft tissue containing the orbital implant. This temporary shell maintains the shape of the eye socket. The temporary shell is left in place and requires no maintenance. After the socket has healed, which is typically one month after surgery, a prosthesis will be made by an ocularist. The prosthesis is molded to fit the unique shape of a patient's eye socket and is painted to match the fellow eye.