Prevention of sympathetic ophthalmia: enucleation or evisceration?

Literary data on the choice of eye removal procedure - enucleation or evisceration - for sympathetic ophthalmia (SO) prevention is presented. In severe penetrating eye injuries when it is impossible to restore eye anatomy during primary surgical treatment and correct light projection is absent, primary evisceration of the damaged eye is recommended. Preventive evisceration should be performed within 2 weeks after injury, which is considered a safe period when SO can be avoided as progressive reduction and scarring of the scleral capsule of the eye has not yet occurred. Evisceration is also recommended for patients with posttraumatic complications consequences and subatrophia with cosmetic purposes. With modern technologies of ophthalmoplastic surgery evisceration, has a number of advantages over enucleation as it provides better stability and motility, fewer complications, good cosmetic results and low risk of developing SO. Enucleation is recommended for patients with chronic posttraumatic uveitis in absence of correct light projections and risk factors of SO. Enucleation is performed with protection of immunosuppressive therapy that should last at least 4 to 6 weeks after the surgery. In case of SO onset, the sympathetic eye should be removed by enucleation as early as possible. For citations: Arkhipova L.T., Filatova I.A. Prevention of sympathetic ophthalmia: enucleation or evisceration? Russian ophthalmological journal. 2017; 10 (4): 97-103. doi: 10.21516/2072 0076-2017-10-4-97-103 (In Russian)