Evisceration of the eye with expansion sclerotomies.

An evisceration procedure is described that permits the use of a large implant, even when the cornea is removed. A recent study has revealed that there is a significant incidence of implant extrusion after the traditional evisceration operation. This new procedure not only permits the use of larger implants when indicated, but the possibility of implant extrusion is minimized by a secure, tension-free anterior wound closure. This is accomplished by the use of multiple sclerotomies that expand the scleral shell, by use of fixation sutures between implant and shell that additionally reduce tension on the wound closure, and by the imbrication of the anterior scleral flaps to enhance the strength of the closure.