Intraconal Implant Placement

Dr. Richard Allen demonstrates placement of a solid spherical implant in a patient undergoing evisceration. He chooses to place the PMMA sphere in the intraconal space posterior to the posterior sclera. This results in an extra layer of sclera over the implant, and decreases the risk of subsequent implant exposure. The posterior sclera is closed with interrupted 4–0 Vicryl sutures. Dr. Allen finds that it is unnecessary to use porous implants unless the surgeon plans to peg the implant at a later date.