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Middle East African Journal of Ophthalmology Middle East African Journal of Ophthalmology
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Year : 2012  |  Volume : 19  |  Issue : 1  |  Page : 24-33

Evisceration in the modern age

1 Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, USA; King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
2 Department of Ophthalmology, The Permanente Medical Group, Redwood City, California, USA

Correspondence Address:
Timothy J McCulley
The Wilmer Eye Institute, Johns Hopkins School of Medicine, 600 North Wolfe Street, Wilmer 110, Baltimore, MD 21287, USA

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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0974-9233.92113

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Evisceration is an ophthalmic surgery that removes the internal contents of the eye followed usually by placement of an orbital implant to replace the lost ocular volume. Unlike enucleation, which involves removal of the entire eye, evisceration potentially causes exposure of uveal antigens; therefore, historically there has been a concern about sympathetic ophthalmic (SO) associated with evisceration. However, critical review of the literature shows that SO occurs very rarely, if ever, as a consequence of evisceration. Its clinical applications overlap with those of enucleation in cases of penetrating ocular trauma and blind painful eyes, but it is absolutely contraindicated in the setting of suspected intraocular malignancy and may be preferred for treatment of end-stage endophthalmitis. From a technical standpoint, traditional evisceration has a limitation in the orbital implant size. Innovations with scleral modification have overcome this limitation, and accordingly, due to its simplicity, efficiency, and good cosmetic results, evisceration has once again been gaining popularity.

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