Scleral Cap Augmentation in Ocular Evisceration.

PURPOSE: To describe an anterior scleral capping technique using human donor sclera or preserved pericardium during ocular evisceration to enable the placement of larger orbital implants. METHODS: Retrospective interventional case series. Six consecutive patients underwent evisceration for blind, painful eyes without infection or suspected intraocular malignancy. 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. Main outcome measures were graft integrity, implant size, successful prosthesis fitting, and postoperative complications. RESULTS: Six patients (mean age 67 years) were included. The mean implant size was 18 mm. Five patients underwent scleral capping, and 1 received a pericardial graft. Five of 6 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 12 months. CONCLUSIONS: Anterior scleral capping during evisceration is a simple technique that allows for the 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.