Types of eye cancer surgery
This page tells you about eye cancer surgery. You can find the following information
Types of eye cancer surgery
Depending on the size of the melanoma and where it is in your eye, you may have an operation to remove just the tumour, part of the eye, or the whole eye. Removing the whole eye is called enucleation.
Orbital implants and artificial eyes
If you need to have your eye removed, your surgeon will usually fit a permanent eye implant into the socket left by removing your eyeball. This is called an orbital implant. Because it is ball shaped, it helps keep the structure of the eye socket. You cannot take the implant out.
A few weeks later, you will have an artificial eye made. This is shaped like a big contact lens and fits over the orbital implant. It is made especially for you, to match your other eye. You take it out to clean it. Modern implants mean you can still have some movement in your artificial eye.
You can view and print the quick guides for all the pages in the treating eye cancer section.
Eye surgery is a very specialist area. So we have not gone into great detail about the operations here. Doctors who carry out eye surgery are called ophthalmologists. Before your surgery, your ophthalmologist will discuss the operation with you and explain how it may affect you afterwards.
Be sure to ask questions as often as you need to, especially about your sight and appearance after the operation. If you only need a small operation, you may not lose the sight in your affected eye. If your surgeon needs to remove your eye (an enucleation), then you will lose the sight in that eye.
Depending on the size of the melanoma and where it is, you may have an operation to remove
Using surgery to remove a tumour from the eyeball is known as a tumour resection. It is often done in combination with radiotherapy. For large melanomas of the eyeball this operation is very difficult.
The operation involves opening your eyeball, which means there is a risk of cancer cells breaking away from the tumour and floating into the surrounding eye tissue. After removing the tumour the surgeon has to put the wall of the eyeball (the sclera) back in place. Unfortunately more than half of all large eye melanomas have already spread into the sclera before the time of surgery. In this case, your surgeon may not be able to remove all of the cancer without removing the eye.
During the operation there is also a risk of
- Your retina becoming detached
- Damage to the lens of the eye, causing cataracts
- Bleeding (haemorrhage)
Depending on where the tumour is, there are several operations surgeons can use to remove parts of the eye
- Iridectomy – this means removing part of the iris and is used for very small melanomas of the iris
- Iridotrabeculectomy – removing the iris and the tissues around the clear layer covering the front of the eye (the cornea), used for small melanomas of the iris
- Iridocyclectomy – this means removing the iris and the ciliary body (the muscle that focuses the eye) and is used to treat small melanomas of the iris
- Choroidectomy – this means removing part of the choroid
The operation is called an enucleation. It means removing your eyeball. Often, this may be necessary for large eye melanomas. But your specialist would only suggest this if it is absolutely necessary.
During the operation your surgeon will remove your eyeball but leave your eyelids, brow and the surrounding skin in place. In most cases, during the operation your surgeon will fit a permanent eye implant into the socket left by removing your eyeball.
In the past, people facing removal of an eye would usually lose any natural movement of the eye. With advances in surgery and the types of eye (orbital) implants now available, better eye movement is possible. Some weeks after your surgery you will have an artificial (false) eye, called an eye prosthesis, fitted over your implant. The prosthesis will be specially made for you, to match your other eye. There may be some situations where using an eye implant is not possible, and you will have only an artificial eye.
The difference between an eye (orbital) implant and an artificial eye can be confusing. This section explains what they are.
An eye implant is often put in as part of the surgery to remove your eye. The implant is usually round like a ball (spherical) and helps to fill some of the volume where your eyeball once was. So it helps keep the structure of the eye socket and supports the artificial eye, which is fitted later. The implant is surrounded by the tissue around the socket and can’t be seen by anybody. It is sewn in place into the tissues of the socket of the eye after your surgeon has removed your eyeball. It is permanent and you can’t take it out.
Although artificial eyes have been around for thousands of years, the first eye implant was only made about 100 years ago. Plastic implants have been used for decades and allow some eye movement. More recently a new type of implant can give better eye movement. These new types of implants are called hydroxyapatite implants. They are made from an artificial form of sea coral. This material is very similar to bone in structure. Blood vessels can grow into it so it can work as part of the normal eye tissue.
About 6 weeks after your surgery you will have a temporary artificial eye fitted. At the same time you will be measured for an artificial eye made just for you. The artificial eye is not round like a ball, but more like the shape of a big contact lens. It will have an eye painted onto it to match your remaining eye. You can take an artificial eye out to clean it whenever necessary. It will move with your eye, although the amount of movement can be limited.
There is information about having an artificial eye in this section.
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