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Complications after Modified Evisceration with Closure of the Anterior Scleral Shell by Donor Scleral GraftKomplikationen nach modifizierter Evisceratio bulbi mit anteriorem Verschluss der Sklera durch ein Transplantat aus Spendersklera
In the last decades, evisceration has become the leading approach for surgery of painful and nonfunctional eyes without malignant diseases . Arguments in favour of evisceration versus enucleation are better preservation of orbital structures, more naturally appearing prosthetic movements, and overall superior aesthetic results. Major complications of evisceration are anterior exposure or extrusion of implants and postoperative socket syndrome caused by insufficient substitution of eye volume.
In order to allow implantation of larger spheres, multiple modifications of standard evisceration have been suggested. Unfortunately, all these techniques afford further surgical steps affecting the integrity of the natural scleral shell, are technically more demanding, and extend the necessary time for surgery. Four years ago, we suggested an easy-to-perform modification of evisceration for larger implants using donor sclera to close the scleral shell anteriorly . This technique has been used so far in two cases. The long-term results should be reported since both developed complications that finally led to the removal of the implants.
Received: 25 September 2020
Accepted: 25 January 2021
30 April 2021 (online)
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- 1 Shah RD, Singa RM, Aakalu VK, Setabutr P. Evisceration and enucleation: a national survey of practice patterns in the United States. Ophthalmic Surg Lasers Imaging 2012; 43: 425-430 doi:10.3928/15428877-20120725-01
- 2 Gerding H, Arendt P. A Novel Technique of Plastic Evisceration for Larger Implants. Klin Monbl Augenheilkd 2016; 233: 413-415 doi:10.1055/s-0041-111808
- 3 Kaltreider SA, Lucarelli MJ. A simple algorithm for selection of implant size for enucleation and evisceration. Ophthal Plast Reconstr Surg 2002; 18: 336-341 doi:10.1097/00002341-200209000-00004
- 4 Soll DB. The anophthalmic socket. Ophthalmology 1982; 89: 407-423 doi:10.1016/s0161-6420(82)34774-0
- 5 Zolli CL. Implant extrusion in eviscerations. Ann Ophthalmol 1988; 20: 127-132 135
- 6 Nadal J, Daien V, Jacques J. et al. Evisceration with autogenous scleral graft and bioceramic implantation within the modified scleral shell: 133 cases over 17 years. Orbit 2019; 38: 19-23 doi:10.1080/01676830.2018.1464584
- 7 Bar-Sela S, Spierer O, Spierer A. Suture-related complications after congenital cataract surgery: Vicryl versus Mersilene sutures. J Cataract Refract Surg 2007; 33: 301-304 doi:10.1016/j.jcrs.2006.10.039
- 8 Bertram BA, Drews-Botsch C, Guell J. et al. Complications of Mersilene sutures in penetrating keratoplasty. Refract Corneal Surg 1992; 8: 296-305
- 9 Fenton S, Kemp EG. A review of the outcome of upper lid lowering for eyelid retraction and complications of spacers at a single unit over five years. Orbit 2002; 21: 289-294 doi:10.1076/orbi.21.4.289.8557