Evisceration via superior temporal sclerotomy

Purpose

To describe evisceration via superior temporal equatorial sclerotomy with preservation of the cornea as an alternative technique.

Design

Retrospective case series.

Methods

Records of 31 consecutive patients who underwent evisceration via superior temporal equatorial sclerotomy between November 1996 and November 2002 were reviewed. Patient age ranged from 1 to 79 years (mean, 27.93 years). Posterior sclerotomies were performed in 14 eyes (45%). The surgical indications, prior ocular surgeries, complications, cornea alterations, cornea sensitivities, size and material of the implants, and the motility of the globes with and without prosthesis were evaluated.

Results

Average follow-up was 31.68 months (range, 5-77 months). No intraoperative complications occurred. One patient had late-term pain due to partial implant extrusion from the melted cornea. All corneas remained clear until the 1st month after surgery. After the 2nd month some corneas became semiopaque (61%) and totally opaque (16%). Seven corneas remained clear (23%). Cornea vascularization started in the second week postsurgery in all patients. It was limited peripherally in six patients and moved forward to the central part in 25 patients. No patient had corneal sensation. In one case, keratitis occurred at month 13 postsurgery; in another, conjunctival dehiscence in the superior temporal region was noted, 26 months after surgery, due to esotropia resulting from pressure exerted on the region by the prosthesis. Globe motility was satisfactory in all patients.

Conclusions

Implant motility is satisfactory and the implant exposure rate is low with this technique.