A new evisceration technique: the caging method

Background To present a new evisceration technique that provides enhanced implant motility in all excursions. Methods This retrospective single-center consecutive case series, conducted between May 2013 and June 2020, included fifteen patients. The technique involves constructing a scleral cage for the orbital implant and ensuring socket resilience against exposure, with modifications based on surgical experience. The key steps include conjunctival peritomy, radial incisions from the recti insertions to the limbus and division of the cornea, scleral flap creation, and cornea preservation with conjunctival coverage. Sphere size is determined by scleral shell capacity. Postoperative follow-up includes assessment of implant motility and convergence/divergence reflexes, with comparison to fellow eyes. Results Among the fifteen patients, 53.33% were male, and 46.67% were female, with a median age of 42 years (range: 16–74). All patients were followed for at least 12 months, with a median follow-up duration of 14 months (range: 12–35 months). Both hydroxyapatite and acrylic spheres were used, with the preference shifting toward acrylic spheres. Implant motility, including six cardinal gaze excursions, showed no statistically significant difference compared to fellow eyes, with maintained incyclotorsion/excyclotorsion and convergence/divergence reflexes observed in all patients. Conclusions A sphere can be placed close to the patient's anatomical position, achieving implant motility in all excursions without any incomitance, similar to that of the fellow eyes of patients.