Complications after Modified Evisceration with Closure of the Anterior Scleral Shell by Donor Scleral Graft

Reconstruction with umbilical amnion following ocular evisceration: A case study

Purpose

To report the use of cryopreserved amniotic membrane from the umbilical cord (UC) in the reconstruction of a dehisced wound with the additional ability to increase orbital volume, expand superior and inferior fornices, and improve cosmesis following evisceration of a blind, painful, atrophic, sunken eye with ptosis.

Observations

Patient developed conjunctival wound dehiscence without implant exposure following evisceration. One month later, reconstruction was performed with UC to cover the defect, increase the orbital volume, and expand orbital fornices to allow placement of a large ocular prosthesis with superior lip for ptosis elevation. Post-operatively, at the 6th week, the socket was healthy and the globe had good movement. At the 7th week, the ocular prosthesis was sized and fitted. At the 8th month, the structural integrity of the socket was maintained with deep fornices, and the patient had excellent cosmetic result with natural appearance and movement of the prosthetic eye.

Conclusions and importance

This case highlights the successful utilization of UC graft to augment soft tissue volume, restore socket structural integrity and increase socket volume, and achieve good cosmesis and ocular motility following evisceration.