AIM: To provide superior cosmetic results and reduce complications, unlike traditional evisceration coupled with implant insertion technique and its modifications, we have developed a novel and simple technique for anophthalmic patients.METHODS: All patients who underwent the scleral-muscle flaps procedure in evisceration with the placement of hydroxyapatite implant were included in the study. Main outcome measures were complications such as exposure, infection, chemosis, conjunctival inclusion cysts, granulomas. Meanwhile, implant motility was indirectly measured and the results were collected and analyzed.RESULTS: A total of twenty-eight patients were enrolled in the study. Eighteen were men (64.29%) and ten were women (35.71%). Ages ranged from 18 to 65y (mean age, 32 years old). Mean follow-up was 12.32mo (range, 9-16mo). All patients received a hydroxyapatite implant. The average diameter of the implant was 19.29±1.36 mm (range, 18-22 mm). Minor complications occurred in 3 patients, and a major complication was observed in 1 patient. Mean motility were 11.04±1.45 mm horizontally (range, 7-14 mm) and 8.57±1.50 mm vertically (range, 5-12 mm).CONCLUSION: The sclera-muscle flaps technique in evisceration with hydroxyapatite implantation is simple and practical that eases the surgical procedure, enables a proper size hydroxyapatite implantation, distinctively reduces complications and provides superior surgery results, especially the motility of the implant.