Patient satisfaction and results after evisceration with a split-sclera technique

A retrospective study of the postoperative results and patient satisfaction after evisceration with a split-sclera technique.

The medical records of 60 patients were reviewed. All patients were operated by evisceration with a split-sclera technique and placement of an orbital implant. The patients were operated by the same surgeon between 1995 and 2003. Multiple-choice questionnaires were sent to the patients, and the patients were also offered a clinical examination.

Extrusion/exposure of the implant was seen in 3/62 (4.8%) orbits. Migration of the implant was seen in one patient. At the time of the study, 45/60 patients were still alive, 32 of these answered the questionnaire. In a question about the patient's psychological well-being after the operation, 9/32 (28%) answered that they had felt depressed; four of these had had a recent trauma to the eye resulting in the evisceration; 25/32 (78%) patients were pleased or very pleased with the operation. A clinical examination was performed in 31 patients. The motility of the prosthesis and implant was measured and found to be rather poor (mean between 2.5 to 4.1 mm in each direction); however, most patients judged their motility to be good or excellent.

Evisceration with a scleral split modification has been used successfully in our clinic since 1995. The risk for exposure is low, 3/62 (4.8%). Postoperative depression was common (9/32). Recent trauma was a risk factor for postoperative depression.