The absence of confirmed cases of sympathetic ophthalmia after evisceration in a large group of patients suggests that the risk for sympathetic ophthalmia is extremely low. Data from Mt. Sinai Medical Center and University Hospitals of Cleveland were collected and histopathologic specimens were reviewed for 51 of 90 patients who underwent evisceration between 1980 and 1996 and who returned for follow-up examinations. Additionally, a survey was sent to members of the American Society of Ophthalmic Plastic and Reconstructive Surgery, the Uveitis Society, and the Eastern Ophthalmic Pathology Society to determine the number of enucleations and eviscerations performed and the documented incidence of sympathetic ophthalmia after evisceration. No clinical or histopathologic evidence of sympathetic ophthalmia after evisceration was found among patients treated at the two medical centers. The collective surveys showed a strong preference for enucleation over evisceration, but did not document evidence of sympathetic ophthalmia after evisceration.
Evisceration is an effective and safe procedure with a low risk for sympathetic ophthalmia.
Eyelid Crease Incision for Lateral Orbitotomy Gerald J. Harris and Sangeeta C. Logani Page 9 Experience with an eyelid crease incision for lateral orbitotomy in approximately 400 patients has shown that the approach affords excellent exposure and minimal risk of complications. The authors describe a surgical incision and technique for lateral orbitotomy that is intended to minimize visible scarring and deformity. This is a noncomparative, interventional, retrospective case series. Other surgical approaches for lateral orbitotomy are briefly reviewed. Criteria are described for inclusion of a bone flap in the technique.