Enucleation and Evisceration: 20 Years of Experience

OBJECTIVETo determine the main clinical indications for surgical removal of the eye in rural areas in Cameroon.DESIGNRetrospective non-comparative case series.PARTICIPANTSA total of 253 patients presenting to the Manna eye clinic Nkongsamba who underwent destructive eye surgery (DES) between January 2006 and December 2010 were reviewed.MAIN OUTCOME MEASUREAge, gender, occupation, prior medication, visual acuity, operation indications, and type of operation.RESULTSThere were 58.10% (n = 147) men and 41.90% (n = 106) women. Median age was 29 years (interquartile range: 14–69 years); age ranged from 10 to 88 years. A total of 67.19% (n = 170) of participants were farmers and lived in rural zones. In all, 79.05% (n = 200) confessed to have trying a medication before the presentation. Surgical indications included infective causes (perforated corneal ulcer 33.20% (n = 84) and endophthalmitis 18.20% (n = 46)), trauma 17.40% (n = 44), painful blind eyes 11.50% (n = 29), malignancy 10.70% (n = 27), and others 9.10% (n = 23).CONCLUSIONThe most common causes of DES in this series could be avoided. Therefore, preventive measures including extensive health education of the public and traditional healers on the risks linked to the use of traditional medicines in ophthalmology and the late presentation of eye disease, quality control of the campaigns that offer free cataract operations in the country.

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“…2) was performed most commonly ( P = 0.033). Similar findings were also reported in other series 3,16. Exenteration (Fig.…”

Section: Discussionsupporting

confidence: 92%

Indications for Surgical Removal of the Eye in Rural Areas in Cameroon

et al. 2014

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“…The differences between procedures based on sex may reflect the cumulative effect of sex distribution and preferred eye removal technique for each pathologic indication. A global trend toward eviscerations has been noted in numerous studies, 5,10,12,28,46 the benefits of which may include improved tissue preservation and cosmetic results, faster recovery, and motility of the prosthetic implant with a low complication rate. 5,10,12,47,48 In cases of suspected neoplasms that cannot be treated with eye-sparing treatments, enucleation is preferred over evisceration.…”

Section: Discussionmentioning

confidence: 99%

“…4 Evisceration may provide better implant motility for the prosthetic eye and may improve cosmetic outcomes. 5 Exenteration is typically reserved for cases of extensive tumour invasion of the orbit 6 or where aggressive treatment is necessary.…”

mentioning

confidence: 99%

A decade of surgical eye removals in Ontario: a clinical-pathological study

Chan

Khattak

Yucel

et al. 2017

Canadian Journal of Ophthalmology

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A blind painful eye and neoplasms were the most commonly documented indications prior to removal of the eye. Common pathologies included glaucoma, neoplasms, infection/inflammation, and trauma. However, regardless of the primary cause, glaucoma-related pathologies were the most common pathologic findings. Refractory eye disease and pain continue to be important reasons for removal of eyes among patients in Ontario. More effective and targeted management strategies are needed to reduce the need for this radical eye surgery of last resort.

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“…Overall, 83.4% of the surgeries were enucleation, 13.4% were evisceration, and 3.2% were exantration, which is consistent with the previous reports. [357] Contradicting this, other studies have reported evisceration as the major surgical approach. [89]…”

Section: Discussionmentioning

confidence: 99%

“…In a recent study from Nigeria, the most prevalent clinical indication of eye surgeries was reported to be infectious causes such as perforated corneal ulcer, endophthalmitis and panophthalmitis (32.1%), trauma (21.2%), and tumors (21.2%), while the most prevalent indication of eye enucleation in children was reported to be retinoblastoma,[2] while several other studies have reported trauma[134] or tumors[5] as the most prevalent cause of enucleation. Often the psychological effects of losing eyes are much worse than its physical problems, especially in cases of losing eyes due to trauma or unexpected malignancy.…”

Section: Introductionmentioning

confidence: 99%

Common causes of eye enucleation among patients

et al. 2017

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Background:We investigated the contributing causes and factors leading to eye enucleation procedure among the patients referred to the ophthalmology clinic of the Center Eye Hospital in Tehran, Iran.Patients and Methods:We retrospectively analyzed the clinical records of patients referred to the ophthalmology clinic of the Center Eye Hospital in Tehran, Iran, in the past 3 years. The data retrieved were analyzed.Results:A total of 313 patients underwent eye enucleation during the past 3 years. The average age of the patients was 36.7 years (range: 20–44 years). Two hundred and eight patients (66.5%) were males and 105 (33.5%) were females. One hundred and sixty-nine patients had the right eye enucleation while 144 patients had the left eye enucleation. The various procedures included enucleation (83%), evisceration (13.4%), and exantration (3.6%). The factors leading to these procedures included trauma (33.2%), phthisis bulbi (20.7%), tumors (15.7%), and infections (10.5%).Conclusion:In our study population, trauma was the main factor leading to eye enucleation. Hence, measures to increase social awareness and knowledge to reduce trauma cases are necessary as a preventive approach to reduce eye enucleation procedures. Concurrently, ophthalmologists should also pay more attention in early diagnoses and screening of eye health, especially detecting tumor cases such as retinoblastoma and postsurgical care to reduce secondary infections will be effective actions to reduce the overall rate of enucleation.

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Enucleation and Evisceration: 20 Years of Experience

Abstract: Evisceration was found to be a safe and quicker alternative to enucleation in our study. A change in surgical preference from enucleation to evisceration was seen during the 20-year study period.

Cited by 57 publications

References 10 publications

Indications for Surgical Removal of the Eye in Rural Areas in Cameroon

Indications for Surgical Removal of the Eye in Rural Areas in Cameroon

A decade of surgical eye removals in Ontario: a clinical-pathological study

Common causes of eye enucleation among patients

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