Safety assessment of the modified evisceration technique in posttraumatic pathology of the eyeball

Abstract

Objective: to assess the safety of evisceration in comparison with enucleation in post-traumatic eyeball pathology.

Methods: 153 patients were examined, from 2016 to 2019, with the outcome of the injury (including surgical), followed by morphological examination of 153 distant eyes of the above patients. Patients are divided into two groups, based on the type of surgical intervention. Group I consisted of 34 patients (34 eyes), the removal of which was carried out by enucleation. Group II included 119 patients (119 eyes), the removal of which was carried out by the method of evisceration according to the developed technique.

Results: Morphological analysis of 34 distant eyes of group I patients by enucleation revealed inflammatory changes in the immune nature in 26 (76.4%) eyes. In a morphological analysis of the removed material of group II (119 removed eyes by the method of evisceration), microscopically, in 31 (26%) cases we observed the phenomena of traumatic uveitis with signs of immune inflammation. In all other microscopically examined eyes, changes characteristic of the outcome of an eyeball injury were observed: the prevalence of fibroblastic processes, the formation of gross fibrotic changes in the eye cavity and, as a result, tractional retinal detachment.

Conclusion The results of the study on large clinical material indicate that with modern evisceration technology with coagulation of emissaries and excision of the inner layers of the sclera, there is practically no risk of CO after it, and the cosmetic and functional result is higher than with enucleation.

Keywords

sympathetic ophthalmia / post-traumatic uveitis / evisceration / enucleation / risk factors / morphological study

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