Modified evisceration technique : post-equatorial sclerectomy and autogenous scleral patching

Abstract EN

Objectives : To describe and evaluate a modified evisceration procedure that is thought to augment the scleral shell volume, allowing the use of a larger-sized orbital implant, and enhancing the strength of the wound.

Methods : A retrospective, descriptive, non-controlled study of evisceration with superior post- equatorial sclerectomy, and patching the wound with autogenous scleral graft was conducted.

We reviewed the files and analyzed the data of 52 patients (eyes) who underwent this technique from September 2003 to March 2011.

Results : Out of 52 patients, 26 were female (50 %) and 26 were males (50 %).

Age ranged from five to 90 years with an average of 47.6 years.

The type of implant was silicone in 49 patients and hydroxyapatite in three patients.

The diameters of the implants ranged between 14 and 20mm; four patients had 14mm, 14 patients had 16mm, 28 patients had 18mm, and six patients had 20mm implants.

The commonest indication for evisceration was trauma in 23 (44.2 %) patients.

None of the patients had implant extrusion, exposure or migration.

No scleral patch melting or displacement was encountered.

The mean follow up period was 35.9 months (1.25 -104).

Conclusion : Technique of evisceration with post-equatorial sclerectomy and sclera patch graft was described.

It was found safe and useful for implantation of larger implants.

However, further comparative study is required.