The most devastating complication of enucleation or evisceration surgery is removal of the wrong eye. Positive surgical site verification should be confirmed with the patient in the preoperative holding area.

Early complications include hemorrhage, infection, and dehiscence of the conjunctiva with exposure or extrusion of the implant. Hemorrhage can usually be avoided by careful hemostasis intraoperatively, and maintaining a pressure patch for the first 48 h postoperatively.

Breakdown of the conjunctival wound usually occurs because the wound was closed under tension, possibly because the implant was too large.^[64–68] It is critical that Tenon's capsule and conjunctiva are closed without tension (Fig. 267.10). A dehiscence may be repaired with a scleral, dermal, or fascial patch graft.^[47,69–71]

Late complications include enophthalmos, ptosis, deep superior sulcus, lower lid laxity, migration of the implant, and dislocation of the motility peg. …