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68 cm2 75. 3 B B B incision cecum carcinomatosis 10 B port C port C port 1 CHAPTER 31 EVISCERATION AND ENUCLEATION 331 TABLE 31-1 PRECAUTIONS TO PREVENT ENDOPHTHALMITIS DEVELOPMENT IN THE PROSTHESIS-WEARING MONOCULAR PATIENT UNDERGOING OPEN GLOBE SURGERY8 Mame Examination of both the prosthetic and the operative sockets for any sign of infection or ot Patient education with regard to personal hygiene and the rationale for the preoperative preparation Preoperative cultures of both conjunctival fornices Topical antibiotics: if the cultures are negative, broad-spectrum antibiotics for 4872 hours; if the cultures are positive, appropriate antibiotic for as long as necessary to prove tto operative field sterile by repeated cultures Removal of tp prosthesis as soon as antibiotic prophylaxis is instituted Perioperatively Preparation of the conjunctivae mzke povidone-iodine Irrigation of the eye with saline solution Microfiltration of all irrigation fluids Preservation of an intact posterior capsule Subconjunctival broad-spectrum antibiotics Postoperatively Antibiotic drops topically Nonocclusive shield without patch Appropriate instructions and careful follow-up with particular attention to complaints of pain or decreased visual acuity Complications of enucleation include: dehiscenceoftheconjunctiva; extrusionoftheorbitalimplant; ptosis; poorocularmotility; enophthalmos; orbitalhemorrhage; orbitalinfection;and contractedsocketsyndrome.
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