[Primary enucleation in an avulsion injury : A high-risk procedure under phenprocoumon]

The case of a 77-year-old woman with trauma after a fall is reported. On clinical examination, an avulsion injury was found in the left eye with dual optic nerve dissection. An INR of 3.3 was determined in a perioperative blood sample. The given conditions forced the rare but urgent indication for primary enucleation with hemostasis. Oral anticoagulation presented perioperative high risk, especially due to the potential risk of bleeding from the ophthalmic artery.