Abstract
AbstractPurposeOur aims were to evaluate the primary and clinical evisceration indications and to analyse orbital implant related complications.Materials/methodsWe included in our retrospective review all eviscerations between 2006 and 2016 at the Department of Ophthalmology of Semmelweis University, Budapest, Hungary. Primary evisceration indications were classified into six groups: trauma, surgical diseases, infections or inflammations, systemic diseases, tumours and unclassifiable diseases. Clinical immediate evisceration indications were also classified into six groups: painful blind eye due to glaucoma, atrophia/phthisis bulbi, endophthalmitis, cosmetic reasons, acute trauma and expulsive bleeding.ResultsEvisceration was performed in 46 eyes of 46 patients (54.3% males, age 43.0 ± 18.6 years). The most common primary evisceration indications were trauma (37%), surgical diseases (34.8%), infection or inflammation (10.9%), systemic diseases (6.5%), tumours (8.7%) and unclassifiable diseases (2.2%). Painful blind eye due to glaucoma (34.8%) was the most common clinical indication for evisceration, followed by atrophia/phthisis bulbi (26.1%), endophthalmitis (17.4%), cosmetic reasons (13.0%), acute trauma (6.5%) and expulsive bleeding (2.2%). After evisceration, 91.3% of the patients received orbital implant and during 26.8±28.9 months follow-up implant related complications were found in 14.3% of the cases, including implant extrusion (4.8%), partial wound dehiscence (4.8%), implant exposure (2.4%) and orbital inflammation (2.4%).ConclusionPainful blind eye and atrophia/phthisis bulbi due to ocular trauma and surgical diseases represent the most common indications for ocular evisceration. If malignant intraocular tumours can be excluded, evisceration surgery combined with a silicon-based orbital implant is a safe and effective procedure.
Highlights
Evisceration surgery is the removal of the intraocular contents after excision of the cornea, while preserving the scleral shell
Primary evisceration indications were classified into six groups: trauma, surgical diseases, infections or inflammations, systemic diseases, tumours and unclassifiable diseases
Clinical immediate evisceration indications were classified into six groups: painful blind eye due to glaucoma, atrophia/phthisis bulbi, endophthalmitis, cosmetic reasons, acute trauma and expulsive bleeding
Summary
Evisceration surgery is the removal of the intraocular contents after excision of the cornea, while preserving the scleral shell. Evisceration surgery can be performed as ‘last resort’ for many severe end-stage ophthalmic conditions with complete loss of the vision (severe ocular injuries, painful eye due to glaucoma, inflammation/infection, or phthisis bulbi) [1, 2]. The technique of evisceration was first described in 1817. The course of the surgery and its indications have continuously changed over the centuries. The first evisceration surgeries were performed by Bear after a case of expulsive bleeding and by Noyes in a patient with endophthalmitis in 1874 [3]. The use of spherical glass implants during evisceration was firstly described by Mules in 1884 [4]
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