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Related Experiment Video

Updated: May 2, 2026

A Simplified Technique for In situ Excision of Cornea and Evisceration of Retinal Tissue from Human Ocular Globe
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The swinging sclera technique for evisceration.

Viana N Phan1, Emma C McDonnell2, Laura T Phan2

  • 1Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School at University of Texas Health Science Center, Houston, Texas, USA.

Orbit (Amsterdam, Netherlands)
|January 28, 2025
PubMed
Summary

This modified evisceration technique uses a full-thickness horizontal sclerotomy to allow larger implants, even in phthisis bulbi cases. Post-operative motility was preserved, demonstrating an effective and stable surgical approach.

Keywords:
Eviscerationphthisis bulbiscleral modification

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Area of Science:

  • Ophthalmology
  • Ophthalmic Surgery

Background:

  • Evisceration is a surgical procedure to remove the eye's contents while preserving the sclera.
  • Standard evisceration techniques may limit orbital implant size, potentially affecting cosmetic outcomes.
  • Phthisis bulbi, a condition of a shrunken, non-functional eye, presents unique challenges in evisceration.

Purpose of the Study:

  • To introduce a modified evisceration technique utilizing a full-thickness horizontal sclerotomy.
  • To evaluate the impact of this technique on post-operative ocular motility.
  • To assess the long-term outcomes and implant stability of the modified evisceration procedure.

Main Methods:

  • A retrospective chart review was conducted on patients undergoing evisceration by a single surgeon.
  • The modified technique involved a complete horizontal sclerotomy at the 3 and 9 o'clock positions, allowing scleral halves to overlap the implant.
  • Post-operative motility was assessed in a subgroup of five patients using photographic analysis in extreme gazes.

Main Results:

  • Thirty patients (16 male, 14 female; mean age 56.9 years) were included in the study.
  • Eleven patients had phthisis bulbi; mean implant size was 19.24 mm.
  • Mean horizontal and vertical motility ratios of operated to non-operated eyes were 0.61 and 0.76, respectively, with no significant difference (p=0.38).

Conclusions:

  • The modified evisceration technique with horizontal sclerotomy effectively accommodates larger implants, even in cases of phthisis bulbi.
  • Dividing the medial and lateral rectus insertions did not compromise ocular motility or implant stability.
  • This technique offers an effective solution for achieving favorable cosmetic and functional outcomes in evisceration surgery.