Enucleation
If you read about cancer surgery or specific surgical topics such as eye surgery, you might encounter the term enucleation. Enucleation means the removal of a tumor or neoplasm, leaving its pseudo capsule behind. If an eye surgeon mentions enucleation, it generally means removing the eyeball, leaving the other structures within the orbital cavity, including eye muscles.
Wide excision was enucleation
in enucleation surgery, the surgeon will directly approach the tumor and take the tumor out without disturbing the surrounding tissues. In wide local excision, the surgeon will remove the tumor with the margin of the surrounding tissue so that he is sure that he has removed all the abnormal tissue without leaving anything inside the body. Since more tissue is taken, it causes more morbidity to the patient.
In cancer surgery, wide local excision is considered superior to enucleation. Enucleation is rarely recommended unless in particular situations.
What are the problems of enucleation?
The main problem of enucleation is the high recurrence rate. This is not a big issue in benign tumors but a significant problem in cancers.
Advantages of enucleation
In general enucleating is easy and does not need a high level of experience. Since less tissue is taken, physiological disturbance to the patient is less. Recovery after enucleation is faster, and immediate surgical complications are rare.
Enucleation in eye surgery
Eye surgeons use the term enucleation specifically to describe the eyeball removal leaving extra-ocular muscles and other structures within the orbital cavity. This contrasts with the exenteration where the eyeball is taken out with the surrounding structures of the eyeball. In evisceration, iris, and cornea removed, leaving behind the extra-ocular muscle and sclera
Enucleation of the eye is done after severe injury to the eye where it is unsalvageable, cancers of the eye like retinoblastoma or end-stage glaucoma.
After removal of the eyeball, a prosthesis can be used to improve cosmetic outcomes.
