Which surgical option for a non-visual eye with primary glaucoma is the most cosmetic but with possible complications?

• A. Evisceration With Prosthesis
• B. Enucleation With Orbital Prosthesis
• C. Cyclocryosurgery
• D. Gonioimplant

Answer: (A)

Preserving orbital tissues while removing just the contents of the eye gives the best cosmetic result when a beige eye has to be made non-visual. Evisceration with a prosthesis leaves the scleral shell and the extraocular muscles in place, and an implant sits inside that shell. Because the muscles attach to the implant through the shell, the prosthetic eye can move more naturally and the eyelids and socket look more like a real eye. That combination typically yields the most natural appearance and symmetry, which is why it’s considered the most cosmetic option.

The trade-off is that this approach carries implant- and socket-related risks. Possible complications include exposure or extrusion of the implant, infection, and inflammatory problems such as sympathetic ophthalmia, though these are relatively uncommon. The other options either remove more tissue or address glaucoma without removing the eye, so they generally don’t offer the same level of cosmetic result.