Kamel, R., Mahmoud, D., Amin, A. (2017). Four Petal Evisceration: Pros and Cons. The Egyptian Journal of Hospital Medicine, 69(4), 2250-2253. doi: 10.12816/0041525
Rehab M. Kamel; Doaa A. Mahmoud; Ahmed M. Amin. "Four Petal Evisceration: Pros and Cons". The Egyptian Journal of Hospital Medicine, 69, 4, 2017, 2250-2253. doi: 10.12816/0041525
Kamel, R., Mahmoud, D., Amin, A. (2017). 'Four Petal Evisceration: Pros and Cons', The Egyptian Journal of Hospital Medicine, 69(4), pp. 2250-2253. doi: 10.12816/0041525
Kamel, R., Mahmoud, D., Amin, A. Four Petal Evisceration: Pros and Cons. The Egyptian Journal of Hospital Medicine, 2017; 69(4): 2250-2253. doi: 10.12816/0041525
1Department of Ophthalmology, Al-Azhar University University, Faculty of Medicine for Girls,
2Department of Ophthalmology, Al-Azhar University University, Faculty of Medicine for Boys
Abstract
purpose: To evaluate four petals evisceration as one of the best modifications in evisceration surgery, allowing the use of large orbital implant with low incidence of complications. Methods: We conducted a retrospective, interventional study on evisceration with placement of spherical non porous orbital implant after four petal evisceration. Preoperative examination included full history, ophthalmological examination, indication for surgery, B-scan ultrasonography, axial length in cases of atrophic and socket surface in secondary cases. All patients were operated a four petal evisceration with spherical non porous implant of size 18 to 22. Postoperative, all patients were followed for at least 6 months for presence of complications, implant and prosthesis motility and the final cosmetic results. Results: 18 eyes were included. Diagnosis necessitating evisceration was atrophia bulbi in 8 patients, endophthalmitis in 2 patients, and implant exposure in 4 patients, corneoscleral melting due to caustic exposure in 1 patient, self-eviscerated globe due to severe trauma in 1 patient and anopthalmic socket following evisceration without implant in 2 patients. Implant size was 18 in 1 patient, 20 in 6 patients, and 22 in 11 patients. No implant exposure occurred; superior sulcus deformity occurred in 3 patients, downward implant migration occurred in 1 patient. Regarding implant motility, it was good with mean of 75% in 14 patients; moderate with mean of 66% in 4 patients. The prosthesis motility was fair with mean of 35% in 12 patients (66.6%) and poor with mean (10%) in 6 patients. Conclusion: Four petals evisceration facilitates the use of large sized implant in all cases even in implant exposure with deficient sclera with good post-operative final cosmetic results, very low rate of complications and moderate prosthesis motility.
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