Purpose

The authors present an evisceration using the four-petal scleral technique, performed by an ophthalmology resident in training.

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Methods

A patient presenting with a blind painful eye underwent preoperative ocular ultrasonography to exclude intraocular tumor. Following confirmation of the absence of malignancy, evisceration was performed using the four-petal scleral technique with primary orbital implant placement.

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Results

Evisceration is a well-established surgical option for the management of blind painful eyes, phthisis bulbi, disfiguring globes, and refractory ocular infections. The absolute contraindication to this procedure is the presence or suspicion of an intraocular tumor; therefore, preoperative imaging — namely ocular ultrasonography — is mandatory prior to surgery.Several surgical techniques have been described, varying according to surgeon experience and preference. The four-petal technique allows a double layer of scleral tissue to reinforce the coverage of the orbital implant, potentially reducing the risk of implant exposure.

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Conclusion

Four-petal scleral evisceration yields satisfactory anatomical and functional outcomes. Notably, the technique demonstrates a relatively rapid learning curve, making it a suitable procedure for acquisition of surgical competence by ophthalmology residents in training.

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Additional Authors

First name	Last name	Base Hospital / Institution
Daniela	Pires	Ophthalmology Department. ULSSA, Porto, Portugal
Tomás	Vaz	Ophthalmology Department. ULSSA, Porto, Portugal
Pedro	Baptista	Ophthalmology Department. ULSSA, Porto, Portugal

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