A modified evisceration technique with scleral quadrisection and porous polyethylene implantation

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

Interventional prospective study.

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.

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.

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