Characterization of evisceration and enucleation following ocular trauma in Medellín, Colombia

Abstract

Abstract Introduction: Ocular trauma is a significant cause of visual loss with long-term sequelae, including reduced quality of life and loss of productivity for young patients. Surgical treatment depends on the injury; enucleation and evisceration are viable options in nonrecoverable eyes. Our study aims to describe the epidemiological and clinical profiles of patients undergoing evisceration/enucleation due to ocular trauma in a tertiary care center in Medellin, Colombia, over 10 years. Methods: We conducted a cross-sectional descriptive study of eyes that were eviscerated or enucleated due to trauma at the SHospital Universitario San Vicente Fundación in Medellin, Colombia, between 2011 and 2021. We studied sociodemographic characteristics, factors related to ocular trauma, and the surgical procedure performed. Results: We studied 161 eyes of 160 patients, of which 2 were enucleated and 158 eviscerated due to ocular trauma. The male-to-female ratio was 7.9:1, and the mean age was 36.6 years (standard deviation = 18.3). 52.2% were due to aggression or violence; the most frequent mechanism was a gunshot wound (28.1%). 98.1% were classified as open ocular trauma, of which 84.5% were ruptured globes. Of the eyes with reported visual acuity, 93.3% did not perceive light. Of the 161 eyes, 58.4% suffered an orbital fracture, and 29.2% suffered cranioencephalic trauma. Primary evisceration was performed in 98.8%, with half of the patients operated in 2 days or less and 75% in 4 days or less. An orbital implant was used in 90.7%. Seventy-five percent of patients were followed up at 36 days. Conclusions: The majority of ocular trauma resulting in loss of the eyeball occurred in young men who had suffered aggression or violence and presented with ocular rupture, with primary evisceration and orbital implant being performed in most cases, in contrast to what is reported in international series where secondary evisceration is preferred, possibly due to the initial severity of the traumatized eyes.