Preoperative Axial Length Measured by Ultrasonography in Phthisis Bulbi

Purpose: The preoperative axial length measured by ultrasonography in the phthisis bulbi and the postoperative surgical outcome was evaluated in order to determine the surgical procedure of an evisceration or enucleation. Methods: The preoperative axial length was measured by ultrasonography in 30 eyes of 30 patients with phthisis bulbi from January 2000 to October 2002. Enucleation was performed on 20 eyes with a relatively short preoperative axial length. The axial length of the enucleated globe was measured and compared with the preoperative axial length. Evisceration was performed in 10 eyes with a relatively long preoperative axial length. The size of the implant, the thickness of prosthesis, and the complications were evaluated postoperatively. Results: In the 20 eyes that underwent enucleation, the preoperative axial length was 6.816.6 mm (mean 12.4 mm) and the axial length of the enucleated globes was 9.020.0 mm (mean 15.3 mm). The size of implants was 16.520.0 mm (mean 19.5 mm). In the 10 eyes that underwent evisceration, the preoperative axial length was 13.522.7 mm (mean 19.1 mm). The size of the implants was 18.520.0 mm (mean 19.4 mm). During a follow-up period of 6-30 months (mean 16.0 months), none of the eyes showed any complications such as conjunctival dehiscence or implant exposure or extrusion. Conclusions: The preoperative axial length measurement was helpful in deciding if enucleation or evisceration of the phthisis bulbi should be performed. Evisceration was performed sufficiently in cases of a preoperative axial length of 16 mm or more.