Flaps conformed to reduced geometry, beveled incisions and bases, and tapered ends maximize vascularity. Additionally, this flap design enhances cosmetic results and maintains a high probability for flap survival. The described novel flap design has many potential advantages over traditional designs. Correctly applied, these flap techniques spare tissue, decrease scarification, trauma and bleeding, and reduce the need for secondary procedures. Potential drawbacks of this flap design include temporary anatomic distortion especially over rounded structures such as the nose.
Complications are minimal.
The medical records of 70 patients who underwent the described evisceration procedure were reviewed. Postoperatively, there were two cases of new or worsened ptosis, no cases of worsened motility, and no cases of implant extrusion. Evisceration with scleral modification is a simple and effective procedure that allows placement of any size orbital implant. Surgical results are excellent with few complications. Four patients, ages 20 to 75 years, had nasal lesions resulting from mucocutaneous leishmaniasis and sought treatment for chronic dacryocystitis.