- Removal of the entire contents of the eye within the scleral shell.
- The sclera and muscles attached to the sclera remain intact to accommodate prosthesis.
- An indication for evisceration is a hopelessly traumatized eye in a young person with no history of previous eye disease.
- The cosmetic result is superior to the result of enucleation because the extrocular muscles remain attached to the scleral shell, resulting in a moveable implant very similar to that of natural eye movement.
- Supine position, slightly elevated or flat.
- Arms are tucked and with soft restraints.
- Ophthalmic packs
- Special eye fenestrated sheet
- Basic pack
- Head or neck pack
- Basic eye procedure tray
- Globe/ orbit prosthesis tray
- Basin set
- Balanced saline solution
- Disposable cautery
- Ophthalmic sponges
- Suction tubing
- Antibiotic ophthalmic ointment
- Sphere prosthesis and conformer
- A periotomy is made superiorly from the 3 o’ clock to the 9 o’clock position.
- An incision (same length) is made in the exposed sclera through to the uvea.
- The entire uvea is separated from the sclera by an evisceration spoon and is completely removed.
- The remaining uvea may be removed with a gauze sponge on a hemostat rotated within the scleral shell or with a special curetite.
- The wound is irrigated and hemostasis is achieved.
- The scleral edges are held open by tagged sutures while the implant is inserted with a sphere introducer.
- The posterior surface of the cornea is removed to reduce sensitivity, and the sclera is closed with interrupted sutures.
- The conjunctiva is approximated.
- A comformer is placed in the cul-de-sac.
- Antibiotic ointment is instilled and an eye pad and metal shield are applied.
Perioperative Nursing Consideration
- Have the prosthesis ready to implant.
- Follow hospital protocol regarding documentation of the prosthesis, and complete the enclosed manufacturer’s form.
- Strict aseptic technique during the entire procedure.
- Educate the patient about the changes and adjustment necessary after the procedure.