Safety assessment of the modified evisceration technique in posttraumatic pathology of the eyeball

Cover Page


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Objective: to assess the safety of evisceration in comparison with enucleation in post-traumatic eyeball pathology.

Methods: 153 patients were examined, from 2016 to 2019, with the outcome of the injury (including surgical), followed by morphological examination of 153 distant eyes of the above patients. Patients are divided into two groups, based on the type of surgical intervention. Group I consisted of 34 patients (34 eyes), the removal of which was carried out by enucleation. Group II included 119 patients (119 eyes), the removal of which was carried out by the method of evisceration according to the developed technique.

Results: Morphological analysis of 34 distant eyes of group I patients by enucleation revealed inflammatory changes in the immune nature in 26 (76.4%) eyes. In a morphological analysis of the removed material of group II (119 removed eyes by the method of evisceration), microscopically, in 31 (26%) cases we observed the phenomena of traumatic uveitis with signs of immune inflammation. In all other microscopically examined eyes, changes characteristic of the outcome of an eyeball injury were observed: the prevalence of fibroblastic processes, the formation of gross fibrotic changes in the eye cavity and, as a result, tractional retinal detachment.

Conclusion The results of the study on large clinical material indicate that with modern evisceration technology with coagulation of emissaries and excision of the inner layers of the sclera, there is practically no risk of CO after it, and the cosmetic and functional result is higher than with enucleation.

Full Text

Restricted Access

About the authors

Irina A. Filatova

The National medical research center of eye diseases named after Helmholtz

Author for correspondence.
Email: filatova13@yandex.ru

M.D., Ph.DD., head of  plastic surgery and ocular prosthetics department

Russian Federation, Sadovaya-Chernogryazskaya str., 14/19, Moscow, 105062, Russia

Viktoriya O. Denisyuk

The National medical research center of eye diseases named after Helmholtz

Email: viktoriya.denisyuk.2012@mail.ru

M.D., postgraduate student at plastic surgery and ocular prosthetics department

Russian Federation, Sadovaya-Chernogryazskaya str., 14/19, Moscow, 105062, Russia

Ihab Jamil M. Mohammad

The National medical research center of eye diseases named after Helmholtz

Email: waheedko@yandex.ru

M.D., PhD. Senior researcher of the plastic surgery and ocular prosthetics department

Russian Federation, Sadovaya-Chernogryazskaya str., 14/19, Moscow, 105062, Russia

References

  1. Аrkhipova LT. Simpaticheskaya oftal’miya. Tver: Triada; 2006. (In Russ).
  2. Аrkhipova LT. Incidence of sympathetic ophthalmia. Myth and reality. Russian ophthalmological journal. 2016;9(3):95–100. (In Russ). doi: 10.21516/2072-0076-2016-9-3-95-100
  3. Filatova IA, Verigo EN, Pryakhina IА, Sadovskaya EP. The role of anatomic and clinical manifestations of trauma in choosing a method of removal of the eye. Russian ophthalmological journal. 2014;7(4):52-59. (In Russ).
  4. Maracheva YaM. Immunopathological variants of the course of posttraumatic uveitis in penetrating injury of the eyeball. Vestnik Ural’skoi meditsinskoi akademicheskoi nauki. 2012;(2):42-44. (In Russ).
  5. Аrkhipova LT, Gundorova RA, Khvatova AV. The epidemiological characteristics and risk factors for sympathetic ophthalmia. Vestnik oftal’mologii. 1996;(4):12-14. (In Russ).
  6. Rao NA. Mechanism of inflammatory response in sympathetic ophthalmia and VKH Syndrome. Eye (Lond). 1997;11 (Pt 2):213-216. doi: 10.1038/eye.1997.54
  7. Аrkhipova LT, Khoroshilova-Maslova IP, Kusnetsova IA, Iluridze SL. Clinico-immuno-morphological parallels for post-traumatic uveitis. Vestnik oftal’mologii. 1999;(4):17-19. (In Russ).
  8. Gundorova RA, Neroev VV, Kashnikov VV. Travmy glaza. Moscow: GEOTAR-Media; 2009. (In Russ).
  9. Gundorova RA, Arkhipova LT, Verigo EN, Kataev MG. Oslozhneniya tyazhelykh pronikayushchikh ranenii, pokazaniya i sposoby udaleniya glaznogo yabloka. Guidelines. Moscow; 2001. (In Russ).
  10. Gundorova RA, Аrkhipova LT, Verigo EN, Kataev MG. Oslozhneniya tyazhelykh pronikayushchikh ranenii, pokazaniya i sposoby udaleniya glaznogo yabloka. Guidelines. Moscow; 2000. (In Russ).
  11. Kilmartin DJ, Andrew DD, Forrester JV. Prospective surveillance of sympathetic ophthalmia in the UK and Republic of Ireland. Brit J Ophthalmol. 2000;84(3):259-263. doi: 10.1136/bjo.84.3.259
  12. Bellan L. Sympathetic ophthalmia: a case report and review of the need for prophylactic enucleation. Can J Ophthalmol. 1999;34:95-98.
  13. Мarak GE. Recent advances in sympathetic ophthalmia. Surv Ophthalmol. 1979;24(3):140-156.
  14. Chan CC, Mochiziki M. Sympathetic Ophthalmia: an autoimmune ocular inflammatory disease. Springer Semin Immunopathology. 1999;21(2):125. doi: 10.1007/BF00810245
  15. Ruedemann AD. Sympathetic ophthalmia after evisceration. Trams Amer Acad Ophthalmol Society. 1963;61:274-314.
  16. Levine MR, Pou CR, Lash RH. The 1998 Wendell Hughes Lecture. Evisceration: is sympathetic ophthalmia a concern in the new millennium? Ophthal Plast Reconstr Surg. 1999;15(1):4-8.
  17. Ruedemann AD. Sympathetic ophthalmia after evisceration. Trams Amer Acad Ophthalmol Society. 1963;61:274-314.
  18. Chu XK, Chan CC. Sympathetic ophthalmia to the twenty-first century and beyond. Ophthalmic Inflamm Infect. 2013;3(1):49-61. doi: 10.1186/1869-5760-3-49
  19. Yousuf SJ, Jones LS, Kidwel ED Jr. Enucleation and evisceration: 20 years of experience. Orbit. 2012;31(4):211-215. doi: 10.3109/01676830.2011.639477
  20. Green WR, Maumenee AE, Sanders TE, Smith ME. Sympathetic uveitis following evisceration. Trans Amer Acad Ophthalmol Otolaryng. 1972;76(3):625-644.
  21. Gurdal C, Erdener U, Irkeç M, Orhan M. Incidence of sympathetic ophthalmia after penetrating eye injury and choice of treatment. Ocular Immunol Inflamm. 2002;10(3):223-227. doi: 10.1076/ocii.10.3.223.15600
  22. Hansen AB, Petersen C, Heegaard S, et al. Review of 1028 bulbar eviscerations and enucleation. Acta Ophthalmol Scand. 1999;77(3):331-335. doi: 10.1034/j.1600-0420.1999.770317.x
  23. Filatova IA, Verigo EN, Pryakhina IA. Removal eye: character ophthalmopathological, clinical manifestation of mechanical trauma, dates, methods of operations. Golova-sheya. 2014;(3):30-35. (In Russ).
  24. Filatova IA, Mohammad IM, Shemetov SA. Modified eyeball evisceration surgery using radio wave surgery technique. Russian ophthalmological journal. 2017;10(3):84-92. (In Russ). doi: 10.21516/2072-0076-2017-10-3-84-92
  25. Verigo EN, Gundorova RA, Sadovskaya EP. Comparative characteristics of the mobility of the stump and the prosthesis depending on the method of removing the eyeball. Rossiiskii oftal’mologicheskii zhurnal. 2012;(2):14-19. (In Russ).
  26. Zheng C, Wu AY. Enucleation versus evisceration in ocular trauma: a retrospective review and study of current literature. Orbit. 2013;32(6):356-361. doi: 10.3109/01676830.2013.764452

Supplementary files

Supplementary Files
Action
1. JATS XML
Download
2. Fig.1 Results of a morphological study of group I (enucleation).

Download (82KB)
Indexing metadata
3. Fig.2 Coloring: GE. Magnification: ×200. Perifocal chorioditis with accumulation of lymphocytes in the form of a nodule (1) subchoroidal

Download (205KB)
Indexing metadata
4. Fig.3 Results of the morphological study of the group (evisceration).

Download (73KB)
Indexing metadata
5. Fig.4 A – a patient with subatrophy and amaurosis of the left eye after a penetrating corneo-scleral wound before surgery.

Download (111KB)
Indexing metadata
6. Fig.4 B – the patient 6 months after evisceration of the left eye with plastic stump orbital implant PTFE. In the cavity, an individual eye prosthesis.

Download (110KB)
Indexing metadata

Copyright (c) 2020 Eco-Vector


СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 86503 от 11.12.2023 г. 
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ЭЛ № ФС 77 - 80630 от 15.03.2021 г.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies