Editor, Removal of an eye following evisceration creates an orbital soft tissue volume deficiency that should be filled with an orbital implant to prevent the postenucleation socket syndrome. A larger implant is preferred for its better cosmetic results although it carries a higher risk of erosion (Toft et al. 2012). We evaluated the relationship of implant size with exposure rate and prosthesis motility in patients who underwent evisceration with and without cornea preservation along with posterior sclerotomy. We also aimed to observe the corneal alterations when the cornea was preserved as recommended (Burch 1939; Ozgur et al. 2005). The medical records of 102 patients underwent evisceration (54 phthisis; 22 endophthalmitis; 17 post-traumatic; nine painful blind eyes) with 4-quadrant posterior sclerotomy were retrospectively reviewed. The mean age was 42.19 ± 15.8 years (21–82) for all patients. Sixty-seven (64.7%) of the patients were men and 35 (34.3%) were women. Group 1 consisted of 53 patients with cornea preservation and group 2 of 49 patients with cornea excision. The mean follow-up period was 61.8 ± 16.7 months (18–158). The Table 1 lists the complications observed and the implant sizes used. We were able to insert 20- and 22-mm implants in 23 patients (43.39%) in group 1 and 16 patients (32.65%) in group 2 (Pearson’s chi-square test; p = 0.362). There was no statistically significant difference between the implant exposure rates of the groups (n = 2 in group 1; n = 4 in group 2; Fisher’s exact test; p = 0.424). There was also no statistically significant difference for implant extrusion rates between the two groups (n = 2 in group 1, n = 2 in group 2, Fisher’s exact test, p = 1.000). Ocular motility was judged by measuring globe movement in extreme gaze positions and comparing it with the normal eye. Motility was observed to be satisfactory in 43 (81.1%) cases in group 1 and 35 (71.4%) cases in group 2 (Pearson’s chi-square test, p = 0.357). None of the patients in group 1 had pain or corneal reflex. Corneal melting developed in two patients 9 and 12 months after the surgery, respectively, due to inappropriate prosthesis fitting. Corneal erosion was noted in two patients; in one of the 2 patients, the cornea was oedematous due to high intraocular pressure before the operation however recovered spontaneously at 1 month. The other patient was treated with lubricating agents. The cornea remained clear in 5 (9.43%) patients, while it was semi-opaque in 28 (52.83%) and opaque in 20 (37.73%). Cornea preservation allowed the use of a larger implant, and it did not significantly affect implant exposure and extrusion rates. It also did not cause any disadvantages as reported (Burch 1939). Good prosthesis motility provides superior cosmesis and thus higher patient satisfaction in terms of an aesthetic result (Toft et al. 2012). Some authors maintain that preserving the cornea may lead to corneal erosion and pain (Wolter & Arbor 1971). We do not agree as the choroid and ciliary plexus are completely removed during evisceration and all ciliary nerve branches are interrupted, innervation of the cornea is less likely (Snell & Lemp 1989). We believe that evidence of any corneal pathology such as melting, keratitis or erosion after the surgery may have other causes such as infection, inappropriate surgical technique, fitting of an inappropriate prosthesis or the pre-operative condition of the cornea. Based on our experience, we think that cornea-preserved evisceration is an efficacious surgical technique because of the possibility of fitting a larger implant that provides better prosthesis motility and hence a better aesthetic result, without increasing the complication rate. We also noted that patients show a more positive attitude towards the procedure when told that only the contents of their eye will be removed and the integrity of the eye shell will be preserved.