Evisceration and Sympathetic Ophthalmia : Is there a risk?

Sympathetic Ophthalmia (SO) is a rare, but devastating eye condition that occurs bilaterally - usually 4-8 weeks after a traumatic event. It is perceived that the risk of SO is eliminated if the injured eye is removed as a primary procedure; and decreased if secondary removal is performed. It is also thought to be safer to remove the eye by enucleation (removal of the entire globe) rather than by evisceration (removal of the globe contents only). Evisceration does, however, have definite advantages over enucleation, including being a technically simpler surgical procedure. Evisceration may become the preferred and accepted procedure for removal of the globe following trauma if it can be conclusively shown that the risk of SO after evisceration is negligible and less than the 0.19% (range 0.1 - 0.3%) quoted in the literature. Many cases of penetrating ocular trauma are seen at Groote Schuur Hospital (GSH) every year - more than at other centres in the world. By analyzing our data over a 10-year period, we hoped to demonstrate that the risk of SO is minimal or non-existent following evisceration for ocular trauma.