The risk of sympathetic ophthalmia following evisceration for penetrating eye injuries at Groote Schuur Hospital

BACKGROUND/AIMS: The aim of this study was to assess the incidence of sympathetic ophthalmia following evisceration for penetrating eye injuries and to assess whether evisceration is safe in this setting. METHODS: Data were obtained retrospectively from patients who were admitted to a tertiary hospital following penetrating ocular trauma over a 10-year period. RESULTS: A total of 1392 patients were included in the study. Of these, 1283 (99.4%) underwent surgery on admission (primary repair or primary removal of the globe). Of the surgical group 889 (64.3%) underwent primary repair, 491(35.5%) had primary eviscerations and three (0.2%) had primary enucleations. Secondary eviscerations were performed on 11 patients who had undergone primary repair. Two cases of sympathetic ophthalmia were identified in the non-surgical group and none in the surgical group. The incidence of sympathetic ophthalmia following penetrating trauma was 0.14%. CONCLUSION: The incidence of sympathetic ophthalmia was low, as found in previous studies. The lack of follow-up, as well as the statistically insufficient number of patients, did not provide conclusive proof that sympathetic ophthalmia does not occur after evisceration. It would appear, however, that evisceration after severe ocular trauma is an acceptable option with a low risk of sympathetic ophthalmia.