Eye removal is a devastating procedure and must be chosen carefully! Currently, most patients who have had their eyeballs removed are implanted with an ocular table, also known as an intraorbital implant. However, no matter how good an intraorbital implant is, it is difficult to replace the delicate anatomical and hematologic connections between the eye and the surrounding tissues; after removal of the eye (even with an eye table), the intraorbital tissues are still slowly undergoing changes such as atrophy, ptosis, and even contracture. Therefore, as an ophthalmologist, one should be very clear about the significance of removing an eye and the value of preserving it, that is, one should neither easily remove an eye that is expected to be preserved nor blindly preserve an eye with latent hidden problems (such as causing sympathetic ophthalmia, etc.); that is, one should take into account the physiological and psychological needs of the patient, as well as medical technology and effectiveness issues, and also consider relevant laws and regulations to avoid Unnecessary medical disputes should be avoided. Ophthalmopexy is a basic surgery, and most people have formed a “stereotypical thinking” about it. Today we will discuss this topic in order to give sufficient attention to the conceptual and technical aspects of some simple procedures. Ophthalmopexy is a destructive surgery aimed at relieving pain in the sightless eye, preventing the spread of malignant tumors, and improving cosmetic appearance. Ophthalmopexy should be performed with strict indications and reasonable use. Although eye removal surgery has been formed as a routine operation, in fact, the process and focus of eye removal surgery are different in different cases. 1, eye rupture injury, emergency eye removal should be particularly cautious, be sure to fully explain the condition and sign the surgical consent form. Many experts specializing in ocular trauma currently emphasize the importance of not doing a phase I eye removal and suturing the ruptured eye as much as possible to give the patient some time to accept the reality of “losing the eye”, a psychological process that is very important. Of course, adequate attention and preventive measures should be given to sympathetic ophthalmia. In cases of severe emergency ocular trauma, where the eye cannot be preserved and the patient has agreed to remove the eye, care should be taken to remove the intraorbital contaminants during the eye removal surgery; in cases where the intraocular tissues are dislodged into the orbit, these tissues, especially the uvea, should be carefully removed; attention should be paid to compound injuries to the eyelids, tear ducts, orbit, and other tissues; immediate implantation of an eye table is not advisable because unclean wounds and compound injuries to surrounding tissues often complicate the situation and make it less safe than second-stage implantation of an eye table. It is not as safe as second stage implantation. 2, for the eye that has been atrophied, no obvious symptoms, when doing the removal of the eye, such as intraocular pressure is too low, in order to prevent the remains of “leakage”, can artificially raise the eye pressure, such as intraocular injection of water. I have improved one point of the routine eye removal surgery: when breaking 4 straight muscle stops, peel off a small piece of lamellar sclera connected with the straight muscle, whose white tissue becomes the distinctive mark of the straight muscle stop, making it easy to find the straight muscle in future eye table implantation surgery. 3, the absolute stage of glaucoma, sometimes due to long-term high intraocular pressure, patients have tolerated and no obvious symptoms, at this time when the removal of the eye more than no special. However, some patients still have very obvious pain, when the removal of the eye more than obvious pain, can be a small amount of anterior chamber release fluid to reduce intraocular pressure, thereby reducing the symptoms of discomfort during surgery. Patients with congenital glaucoma often have corneoscleral chylomalacia, and special care should be taken not to puncture it during surgery. In addition, for patients with closed-angle glaucoma, the pupil reduction agent should be given to the contralateral eye immediately after removal of the eye, and observation should be made to prevent acute attacks of glaucoma. 4, patients with intraocular inflammation (such as uveitis), the pain during surgery is more obvious, to give an adequate amount of anesthesia, preferably with a mixture of 2% lidocaine and 7.5% bubivocaine (1:1), local injection should be given sufficient time to work, the analgesic effect is good. 5, congenital small eye, may be combined with intraorbital cysts, careful examination should be done before surgery, orbital CT etc. if necessary to understand the situation. If there are intraorbital cysts, they should be removed together and the cystic cavity should be filled. 6. After severe eye trauma, such as orbital fracture, the wall of the eye may adhere to the surrounding soft tissues or even the orbit, making surgery difficult, and postoperative post-operative post-operative symptoms such as ocular muscle movement disorders and conjunctival sac stenosis may occur, which should be fully explained before surgery. Those with heavy intraorbital soft tissue scarring should also not implant the eye table in one phase. 7. In case of silicone oil eye removal surgery, if the eye is punctured, the silicone oil flowing into the orbit should be flushed out to prevent adverse reactions in the orbital tissues. 8.Severe lid bulb adhesions are often secondary to chemical or thermal burns, and there may be melting and grapevine swelling of the anterior segment bulb wall, etc. Pay attention to the problem of perforation of the eyeball if eye removal is done. 9. For intraocular malignant tumors, the removal of the eyeball should be done with extra gentle and meticulous movements, without putting pressure on the eyeball, and if necessary, an external canthotomy should be made to facilitate the surgical operation. The length of the optic nerve should be cut. For intraocular malignant tumors, the longer optic nerve should be cut as much as possible, but the optic nerve should not be stretched outward excessively to avoid intracranial hemorrhage caused by the retraction of the optic nerve in the canal. For non-neoplastic ophthalmic removal surgery, my experience is to flatten the posterior wall of the eye to break the optic nerve, which can reduce the damage to the intraorbital soft tissues. 10, pediatric general anesthesia to do eye removal, but also repeatedly check the eye, careful to prevent the removal of the wrong eye. 11.Eyes removed in any case are sent for pathological examination, to form a routine. Finally, it is worth mentioning that patients may have very different attitudes toward eye removal. Some people think that this bad eye is not only visionless and unattractive, but also has the risk of sympathetic ophthalmia, so they strongly agree to remove it; others always feel that it is better to have their own, and they would rather endure some pain and take some risks than refuse to remove the eye. From the doctor’s point of view, the initial goal of any treatment is to minimize damage and avoid some possible postoperative problems. One patient who had an ocular table implant told me that his injured eye was always cold, especially in winter. I specifically asked patients who had prosthetic eyes after corneal occlusion and they did not noticeably feel the above. This shows that no matter how good an intraorbital implant is, it is difficult to replace the delicate anatomical and hematological connection of the eye to the surrounding tissues. Therefore, we have to be very careful about eye removal, i.e., we have to consider the physiological and psychological needs of the patient and the relevant legal issues to avoid unnecessary medical disputes.