PURPOSE: To determine whether volumetric calculation of enucleation implant size improves the results of the enucleation procedure.METHODS: The volume of the enucleated globe was measured in 33 eyes of 33 patients, allowing intraoperative calculation of implant size. The degree of postoperative anophthalmic volume deficit was evaluated by determining the relative enophthalmic position of the implant using Hertel exophthalmometry. These results were compared with those obtained from two groups of historical control patients who had previously undergone enucleation with the insertion of standard size 18-mm or 20-mm implants.RESULTS: There was significant variability in the volume of 'normal' size globes (range, 7.0 to 9.0 ml; mean, 7.9 ml; standard deviation [SD], 0.7), resulting in the placement of implants between 18 to 22 mm in diameter. Study patients undergoing volumetric determination of implant size demonstrated less implant enophthalmos (mean, 5.9 mm) than historical control patients who received 18-mm (mean, 8.5 mm; P = .0001) or 20-mm (mean, 6.8 mm, P = .0332) implants.CONCLUSIONS: Volumetric determination and individualization of enucleation implant size appears to reduce postoperative anophthalmic volume deficit. Copyright (C) 1999 Elsevier Science Inc.