Three excellent articles bear witness to the current interest in evisceration.1-3 The indications, contraindications, and the advantages of Burch's type of evisceration over enucleation have been reviewed thoroughly. Evisceration offers better cosmetic results if the cornea is retained than if the cornea is removed.1-4
As with enucleation, extrusion of the scleral implant does occur with evisceration. Excessively thin corneal tissue, in an elderly patient or from a prolonged disease process, predisposes extrusion of the implant through a break in the cornea. Ruedemann 2 mentioned 7 extrusions of the implant in a series of 198 eviscerations. He suggested that corneal erosion will develop if clearance of the prosthesis is not adequate. Because the cornea is the weakest segment in the eviscerated eye, a simple procedure to secure greater protection against extrusion of the scleral implant is recommended.
After Burch's evisceration is completed, the corneal epithelium is scraped away
VEIRS ER. EviscerationA Procedure for Reinforcing the Cornea. Arch Ophthalmol. 1961;65(5):621-625. doi:10.1001/archopht.1961.01840020623003