View 2019 Abstracts

To evaluate the outcomes following emergency eviscerations with orbital implants in a tertiary centre. The primary objective was the rate of orbital implant exposure, in a situation where eye removal was necessary in an emergency setting.

All patients who underwent evisceration in this unit between January 2006-August 2018, inclusive, were identified. Only the patients who had an evisceration in an acute setting where the globe was deemed no longer intact or at a high risk of spontaneous perforation were included.

There were 26 eyes in 26 patients. The indications for emergency evisceration were infectious corneal perforation (16), non-infectious corneal perforation (3), endophthalmitis ± corneal perforation (5), and globe rupture (2). Primary orbital implantation was done in all except for 2, due to the extent of infection. The implants used were acrylic (15), silicone (4) and Medpor (5). There were 2 cases of implant exposure (silicone – 1, acrylic – 1). Both cases required emergency eviscerations for infectious corneal perforation. The silicone case was treated with replacement by another silicone implant following scleral reformation. The acrylic case was treated with implant removal and replacement with a dermis fat graft .

Performing emergency orbital evisceration and implantation is relatively uncommon. We had 26 cases in 12 years. The implant exposure rate was 2/26 (7.6%). We would strongly advocate primary orbital implantation at the same time as the emergency evisceration. The implant exposure rate following primary orbital implantation is acceptable; and with or without implant exposure, patients have good functional outcomes.