EVISCERATION

It is the removal of the contents of the eyeball leaving
behind the sclera. Frill evisceration is preferred over
simple evisceration. In it, only about 3-mm frill of the
sclera is left around the optic nerve.
Indications. These include: panophthalmitis,
expulsive choroidal haemorrhage and bleeding
anterior staphyloma.
Surgical steps of frill evisceration (Fig. 7.21)
1. Initial steps upto separation of the conjunctiva
and Tenon’s capsule are similar to enucleation.
2. Removal of cornea: A cut at the limbus is made
with a razor blade fragment or with a No. 11
scalpel blade and then the cornea is excised with
corneoscleral scissors.
3. Removal of intraocular contents: The uveal
tissue is separated from the sclera with the help
of an evisceration spatula and the contents are
scooped out using the evisceration curette.
4. Separation of extraocular muscles is done as for
enucleation.
5. Removal of sclera: Using curved scissors the
sclera is excised leaving behind only a 3-mm frill
around the optic nerve.
6. Closure of Tenon’s capsule and conjunctiva and
other final steps are similar to enucleation.