title: Comparing outcomes of enucleation and evisceration.
abstract: OBJECTIVE
  To compare clinical outcomes of enucleation and evisceration by functional and aesthetic measures.
  
  
  METHODS
  Retrospective, nonrandomized, comparative analysis.
  
  
  METHODS
  Eighty-four patients who underwent enucleation or evisceration.
  
  
  METHODS
  The medical records of the participants were retrospectively reviewed. Clinical photographs were graded by blinded observers for qualitative measures.
  
  
  METHODS
  Postoperative eyelid and motility measurements, as well as subjective grades of various aesthetic and functional outcomes.
  
  
  RESULTS
  There is no statistically significant difference in the overall aesthetic outcome of enucleation and evisceration, although several specific comparisons were found to be significant. Implant motility score is higher in eviscerated eyes (5.58+/-2.08) than in enucleated eyes (4.35+/-1.69) (P = 0.05). Adduction of the implant is significantly less than abduction in eviscerated eyes (1.34 vs. 1.44; P = 0.02). Implant motility is greater than prosthesis motility. Both enucleation and evisceration result in enophthalmos and a sulcus defect. Seven of 32 patients (21.9%) who underwent enucleation experienced a complication, whereas only of 7 of 52 patients (13.5%) who underwent evisceration experienced a complication (P = 0.0002). The 2 most common complications were implant exposure and formation of a pyogenic granuloma.
  
  
  CONCLUSIONS
  Although enucleation and evisceration produce aesthetically similar outcomes, eviscerated eyes have better implant motility and experience fewer complications. Both enucleation and evisceration result in enophthalmos, sulcus contour defects, and incomplete transfer of implant motility to the prosthesis.
authors.affiliation: Jules Stein Eye Institute and Department of Ophthalmology, David Geffen School of Medicine, UCLA, Los Angeles, California 90095-7006, USA. nakra@jsei.ucla.edu
authors.forename: Tanuj
authors.initials: T
authors.lastname: Nakra
authors.forename: Guy J Ben
authors.initials: GJ
authors.lastname: Simon
authors.forename: Raymond S
authors.initials: RS
authors.lastname: Douglas
authors.forename: Robert M
authors.initials: RM
authors.lastname: Schwarcz
authors.forename: John D
authors.initials: JD
authors.lastname: McCann
authors.forename: Robert A
authors.initials: RA
authors.lastname: Goldberg
mesh_terms: D001766:Blindness / Q000601:surgery; D004954:Esthetics; D015353:Eye Enucleation; D017234:Eye Evisceration; D005134:Eye Neoplasms / Q000601:surgery; D005260:Female; D005548:Foreign-Body Migration / Q000209:etiology; D017789:Granuloma, Pyogenic / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009799:Ocular Physiological Phenomena; D020273:Orbital Implants; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome