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This Concept Map, created with IHMC CmapTools, has information related to: Enucleation, Using Metzenbaum scissors, create a plane of dissection to release the globe from the remaining tissues that are attaching it to the orbital rim. step 6 Ligating the optic nerve and surrounding blood vessels. Sever the optic nerve and posterior ciliary arteries by using curved Metzebaum scissors., Make elliptical full-thickness incisions about 5 mm away from the eyelid margins,and join the incisions at the medial and lateral canthus step 3 Using Allis tissue forceps or towel clamps, grasp the incised eyelid margin. Start blunt dissection by using curved Metzenbaum scissors, alternating sides until you approach the sclera., Transpalpebral (MO) step 1 Suture the eyelids closed (MO), Ligating the optic nerve and surrounding blood vessels. Sever the optic nerve and posterior ciliary arteries by using curved Metzebaum scissors. step 7 Remove the globe then pack the orbit with gauze, and apply pressure for at least five minutes., Suture the eyelids closed (MO) step 2 Make elliptical full-thickness incisions about 5 mm away from the eyelid margins,and join the incisions at the medial and lateral canthus, Remove the globe then pack the orbit with gauze, and apply pressure for at least five minutes. step 8 Close the orbit with a minimum of three layers. Start along the periosteum of the anterior orbital rim with bites 3 to 4 mm apart in a taut simple continuous pattern using 3-0 or 4-0 monofilament polyglyconate synthetic absorbable suture to create a periosteal mesh., Enucleation types Transpalpebral (MO), Enucleation types Transconjunctival, Using Allis tissue forceps or towel clamps, grasp the incised eyelid margin. Start blunt dissection by using curved Metzenbaum scissors, alternating sides until you approach the sclera. step 4 Release the globe by ligating the medial and lateral canthal ligaments and blood vessels, then transecte them, Release the globe by ligating the medial and lateral canthal ligaments and blood vessels, then transecte them step 5 Using Metzenbaum scissors, create a plane of dissection to release the globe from the remaining tissues that are attaching it to the orbital rim., Suture the next two or three layers in a simple continuous pattern by using 3-0 absorbable braided or monofilament sutures. To decrease the risk of swelling and dehiscence, the tissue should come in contact without gaps, and the suture lines spanning across should not be visible. step 10 Place skin sutures by using 4-0 monofilament synthetic nonabsorbable sutures in a cruciate or simple interrupted pattern., Close the orbit with a minimum of three layers. Start along the periosteum of the anterior orbital rim with bites 3 to 4 mm apart in a taut simple continuous pattern using 3-0 or 4-0 monofilament polyglyconate synthetic absorbable suture to create a periosteal mesh. step 9 Suture the next two or three layers in a simple continuous pattern by using 3-0 absorbable braided or monofilament sutures. To decrease the risk of swelling and dehiscence, the tissue should come in contact without gaps, and the suture lines spanning across should not be visible.