60Evisceration

See Chapter 58.

Select cases of intraocular infection in blind eyes.

Debilitated patients for whom a short procedure or local anesthetic is preferred.

Patients for whom cosmetic outcome is of particular importance and can accept risk of sympathetic ophthalmic.

Contraindications

Intraocular tumor

Ocular condition for which histopathologic examination is necessary

Severely traumatized eye

Preoperative Procedure

See Chapter 3.

1. Treat any infectious processes as necessary.

2. Make certain eye is not harboring malignancy.

a. Perform ultrasound examination or magnetic resonance imaging scan if entire fundus cannot be visualized.

3. Select type of implant to be used. Silicone and methylmethacrylate are low cost and relatively inert. Hydroxyapatite and porous polyethylene (Medpor) allow for vascularization and later pegged prosthesis if better prosthetic movement is desired.

Instrumentation

Lid speculum

Toothed forceps

Sutures (6–0 Vicryl, 6–0 plain)

Needle holder

Corneoscleral and Westcott scissors

Cautery

Microsurgical knife

Evisceration spoon

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