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Four Petal Evisceration Inphthisical Eyes


Article Information

Title: Four Petal Evisceration Inphthisical Eyes

Authors: Murtaza Sameen, Muhammad Shahid, Muhammad Awais, Muhammad Adnan, Teyyeb Azeem, Hussnain Abbas

Journal: Pakistan Armed Forces Medical Journal (PAFMJ)

HEC Recognition History
Category From To
Y 2024-10-01 2025-12-31
Y 2023-07-01 2024-09-30
Y 2021-07-01 2022-06-30
Y 2020-07-01 2021-06-30
Y 1900-01-01 2005-06-30

Publisher: Army Medical College, Rawalpindi.

Country: Pakistan

Year: 2023

Volume: 73

Issue: Supplementary 2

Language: English

DOI: 10.51253/pafmj.v73iSUPPL-2.8718

Keywords: EviscerationFour petalOrbital implantPhthisical eyes

Categories

Abstract

Objective: Four Petal Evisceration Inphthisical Eyes.
Study Design: Retrospective Study.
Place And Duration of Study: Armed Forces Institute Of Ophthalmology, Rawalpindi Pakistan, from Jan 2022 to Apr 2022.
Methodology: A total of 20 subjects underwent evisceration with four petal technique. The record was collected from record room and data was analyzed. After 360º conjunctival peritomy, a larger orbital implant was placed for good cosmesis and to achieve maximum ocular motility. Axial length (AL) of normal eye was measured and compared with AL of atrophic eye. An orbital implant 3mm smaller than the axial length of the normal eye was placed. Implant was closed with 4 coverings to prevent extrusion. SPSS version 22.0 was used for data analysis.
Results: Out of n=20 patients with atrophia bulbi, females 11(55%) and males 9(45%). About 12(60%) were right eyes and 08(40%) were left eyes. Mean SD age of patient was 35.1±17.01 years. An implant of 18mm, 20mm and 22mm were used after calculation of axial length. Axial length of normal eye was used for the selection of size of implant. However, follow up was done from 4-18 months respectively.
Conclusion: Evisceration with four petals remains the procedure of choice due to better cosmesis and good motility.


Research Objective

To evaluate the effectiveness of the four-petal evisceration technique in phthisical eyes for improved cosmesis and ocular motility.


Methodology

Retrospective study involving 20 subjects who underwent four-petal evisceration. Data was collected from hospital records. The technique involved a 360º conjunctival peritomy, placement of a larger orbital implant (3mm smaller than the axial length of the normal eye), and closure with four layers of support. SPSS version 22.0 was used for data analysis.

Methodology Flowchart
                        graph TD;
    A["Data Collection from Records"] --> B["Patient Selection: n=20, Four Petal Evisceration"];
    B --> C["Perform Four Petal Evisceration"];
    C --> D["Place Larger Orbital Implant"];
    D --> E["Close with 4 Layers of Support"];
    E --> F["Data Analysis using SPSS v22.0"];
    F --> G["Evaluate Cosmesis and Motility"];
    G --> H["Report Findings"];                    

Discussion

The four-petal evisceration technique allows for the placement of larger orbital implants, which is crucial for better cosmesis and adequate eye movement. The study found this technique to be effective, with a low complication rate compared to other methods. The selection of implant size based on the axial length of the normal eye, with a 3mm reduction, proved adequate.


Key Findings

Out of 20 patients, 11 (55%) were female and 9 (45%) were male. 12 (60%) were right eyes and 8 (40%) were left eyes. The mean age was 35.1±17.01 years. Implants of 18mm, 20mm, and 22mm were used. One case (5%) experienced implant extrusion, and one case (5%) presented with a deep superior sulcus due to inferior implant displacement.


Conclusion

Evisceration with the four-petal technique is the procedure of choice for phthisical eyes, offering superior cosmesis and good motility due to the placement of larger orbital implants and fewer postoperative complications.


Fact Check

* A total of 20 subjects underwent the four-petal evisceration technique. (Confirmed in Results section)
* 11 out of 20 patients (55%) were female. (Confirmed in Results section)
* The study was conducted from January 2022 to April 2022. (Confirmed in Methodology section)


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