Evisceration: Is sympathetic ophthalmia a concern in the new millennium?

Purpose: To investigate a possible relationship between evisceration and sy mpathetic ophthalmia. Methods: Data from Mt. Sinai Medical Center and University Hospital of Clev eland were collected and histopathologic specimens were reviewed for 51 of 90 patients who underwent evisceration between 1980 and 1996 and who return ed for follow-up examinations. Additionally, a survey was sent to members o f the American Society of Ophthalmic Plastic and Reconstructive Surgery, th e Uveitis Society, and the Eastern Ophthalmic Pathology Society to determin e the number of enucleations and eviscerations performed and the documented incidence of sympathetic ophthalmia after evisceration. Results: No clinical or histopathologic evidence of sympathetic ophthalmia after evisceration was found among patients treated at the two medical cent ers. The collective surveys showed a strong preference for enucleation over evisceration, but did not document evidence of sympathetic ophthalmia afte r evisceration. Conclusions: Evisceration is an effective and safe procedure with a low ris k for sympathetic ophthalmia.