c l i n i c a l f o l i o s : n a r r a t i v e





A D V E R T I S E M E N T

 

Ocular Trauma: 4

A D V E R T I S E M E N T

   
 

The optic nerve is exposed under traction and the grossly contaminated globe remnant is removed.       

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Ocular Trauma: 5

A D V E R T I S E M E N T

   
 

The billowing orbital fat is deleted in this illustration allowing a view of the orbital apex. The orbital fat is enveloped in a multi-laminated fine fascial envelope of septum and posterior tennonís tissue. The surgeon retracts the orbital fat and irrigates and debrides one quadrant at a time.      

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Ocular Trauma: 6

A D V E R T I S E M E N T

   
 

Fornix expansion with a well-fit conformer and temporary suture tarsorrhaphy promote future ocular prosthetic comfort. An acrylic sphere of the appropriate size is placed deep into the orbit. Dense white tennonís fascia from deep in the orbit is closed over the implant. Posterior tennonís fascia is the principle tissue with marked strength to prevent implant extrusion and reduce tension on the overlying conjunctiva. Remnants of the vertical intramuscular capsule can be incorporated with a horizontal closure of intermediate tennonís fascia prior to final closure of the conjunctiva. A minimum of strategically placed sutures is important in these grossly contaminated wounds.     

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This page was last modified on 3/22/2006.