The following sections offer specific information about aspects of surgery and patient care that are important in acheiving a good surgical result. While this debate is by no means concluded, some consider that an evisceration yields the best cosmetic result because it is less damaging to the structures of the orbit. However, there are many cases in which an enucleation may be indicated. Evisceration An evisceration is indicated in the cases listed above, where an enucleation is not specifically indicated.
Some surgeons prefer an evisceration over an enucleation wherever possible.
Classically, the clearest indication for an evisceration has been in cases of virulent endophthalmitis, to reduce the risk of the infection spreading via the optic nerve sheath. In addition, an evisceration is often less psychologically traumatic for the patient because it involves the loss of what is perceived as only a portion of the eye, as compared with the entire eye. A secondary implant has been traditionally indicated in cases of chronic exposure, migration, or extrusion of the primary implant. In most cases, the motility provided by the Bio-eye HA ocular implant hydroxyapatite implant is equal to or better than that provided by the primary implant. If the rectus muscles can be identified and attached directly to the implant, even greater motility can be expected.