Purpose

To describe a novel anterior scleral capping technique using human donor sclera or preserved pericardium during ocular evisceration to enable placement of larger orbital implants.

---

Methods

Retrospective interventional case series including patients undergoing evisceration for blind, painful eyes without infection or suspected intraocular malignancy.
Surgical technique:
Following standard evisceration, the largest possible spherical implant was inserted. A human donor scleral button (5 cases) or preserved pericardium (1 case) was sutured to the anterior scleral surface as a cap over the implant. Patients were followed clinically, with evaluation of graft integrity, prosthesis fitting, and complications.

---

Results

Six patients (mean age 67 years) were included. The mean implant size was 18 mm. Five patients underwent scleral capping and one received a pericardial graft. Five of six patients had an uncomplicated postoperative course, with intact grafts and successful prosthesis fitting. One patient developed partial graft dehiscence requiring implant exchange with a smaller implant. No implant exposures were observed over a mean follow-up of 11 months.

---

Conclusion

Anterior scleral capping during evisceration is a simple technique that allows placement of larger orbital implants without additional scleral incisions. Early results demonstrate good graft integration and favorable short-term outcomes. Larger studies with longer follow-up are needed to evaluate long-term safety and potential impact on post-enucleation socket syndrome.

---

Additional Authors

First name	Last name	Base Hospital / Institution
Eran	Levanon	Sheba Medical Center
Guy	Ben-Simon	Sheba Medical Center

↑ Back to top