60 See Chapter 58. 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.
Evisceration
Indications
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
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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