A modified evisceration technique with scleral quadrisection and porous polyethylene implantation

Abstract

Purpose: To propose and evaluate a modified evisceration technique that aiming to minimize the extrusion or exposure and improve motility of the implant.

Design: Interventional prospective study.

Methods: There were 154 patients referred to our clinic from March 1, 2003 to March 1, 2007. All the patients underwent the primary evisceration and implantation of a porous polyethylene implant using the modified technique, which included quadrisecting the sclera, suturing the implant with each rectus muscle through the scleral petal, and then covering the implant with 2 layers of the sclera. Main outcome measures were complications such as conjunctival dehiscence, implant extrusion, implant exposure, significant enophthalmos, superior sulcus deformity or orbital cellulitis, and cosmetic outcome.

Results: All patients received porous polyethylene implants with 18 mm or larger sphere. In a mean 3.5 years follow-up period (range, 1 to 5 years), there was no case of conjunctival dehiscence, implant extrusion, implant exposure, significant enophthalmos, superior sulcus deformity, or orbital cellulitis. The cosmetic appearance and implant mobility were satisfactory.

Conclusions: This technique appears to be an excellent modification for anophthalmic socket reconstruction.