Anophthalmic Sockets: A Retrospective Review of Enucleations, Eviscerations, and Exenterations Performed and Managed in a Tertiary Care Hospital

Background/Objectives: Enucleation, evisceration, and exenteration remain essential in ophthalmic practice, despite advances in medical and surgical care. Optimal outcomes rely on meticulous technique, implant selection, and long-term socket rehabilitation. This study reports a single surgeon’s 15-year experience managing anophthalmic sockets at a tertiary referral hospital in Southeast Asia. Methods: A retrospective review was conducted. Clinical records were examined for demographics, indications, type of surgery, implant characteristics, wrapping material, complications, and secondary interventions. Results: A total of 175 anophthalmic sockets were managed (82 primary, 88 secondary). Mean age was 34.1 ± 30.0 years, 54.9% males. The most common indications were ocular/orbital tumors and trauma. Among primary cases, 70 underwent enucleation, 7 evisceration, and 5 exenteration. The most common implant placed was porous polyethylene (Medpor). Donor sclera was the most frequently used wrapping material. Fifteen (18.3%) primary sockets developed postoperative complications, implant exposure being the most common. Among secondarily managed sockets, more than half had severe complications, particularly severe socket contraction and post-enucleation socket syndrome. Conclusions: Anophthalmic sockets remain a complex and challenging condition in ophthalmic practice. Tumors and trauma were the leading indications for globe removal in this cohort. Despite refinements in surgical technique, complications persist, emphasizing the need for multidisciplinary, long-term care to optimize functional and aesthetic outcomes.