gms | German Medical Science

Purpose: I perform evisceration surgery in blind, disfigured and painful eyes, when there is no suspicion of intraocular tumors. I have not seen any sympathetic ophthalmias in hundreds of eviscerations that I have performed so far. I want to mention about new evisceration techniques which provide good esthetic results and reduction of complications. This gives excellent results when compared to classical evisceration.

Methods: Currently I have been performing evisceration with radial sclerotomies for 20 years. In this procedure the cornea is removed, the ocular contents are removed, the sclera is bisected into two flaps, avoiding damage to recti muscles. The scleral flaps are relieved form their posterior attachments to the optic nerve. (Upper and lower scleral flaps are separated from each other and they are also separated from the optic nerve.) Two recti muscles remain attached to each scleral flap. Usually a 22 mm spherical implant is placed behind scleral flaps. The scleral flaps are closed over the implant with 5-0 absorbable sutures.

Results: Radial sclerotomies and optic nerve release allow tension-free closure of scleral flaps over a large implant. Scleral expansion allows placement of large implants even in phthisical globes.

Conclusions: This procedure has lower risk of complications and implant exposure. This is a straightforward, quick and reliable procedure that yields excellent results when compared to classical evisceration.