Abstract
This study aimed to assess the indications for destructive eye surgeries (DES) among children and ascertain the proportion avoidable. The Eye theatre register was retrospectively reviewed. Data on children who had DES from 1st January 2008-31st December 2017 was retrieved. These included biodata; clinical presentation, diagnosis, indication and type of surgery, and outcome of management. The total number of paediatric ophthalmic surgeries within the study period was computed. The data were entered into Epi Info statistical software, version 3.4 for analysis. Descriptive and analytical statistics were applied, p-values < 0.05 were considered statistically significant. A total of 634 ophthalmic surgeries were performed on children within the study period, 50(7.9%) eyes of 49 children had destructive eye surgeries. Thirty-three (67.3%) were males and 16(32.7%) were females; M:F ratio was 2.1:1. The mean age was 6.7±5.0 years with a range of 1.7-11.7years (Mean±SD). Most, 27(55.1%) of the participants had evisceration, 15(30.6%) had enucleation while 7(14.3%) had exenteration. More males, 24(72.7%) had evisceration while more females 10(62.5%) had enucleation (Fisher’s exact test=13.8, p=0.001). The main indications for DES included tumour in 22(44%) eyes, trauma to eyes in 13(26%) and intractable infections in 8(16%) eyes. All the 15 eyes enucleated were confirmed cases of retinoblastoma. Seven (14.3%) persons had orbital exenteration of which 6(85.7%) were retinoblastoma. In all, 42(84%) destructive eye surgeries in this study were avoidable. There is a need for improved enforcement of the “Child’s Right Act” in our environment.
Highlights
This study assessed the indications for destructive eye surgeries (DES) among children and ascertained the proportion avoidable
Indications include intraocular malignancy, a painful blind eye and unsightly blind eye.1`In order to achieve acceptable cosmetic outcome and symmetrical growth of the face, both enucleation and evisceration are usually accompanied by surgical placement of an orbital implant
A total of 634 paediatric ophthalmic surgeries were performed during the study period
Summary
This study assessed the indications for destructive eye surgeries (DES) among children and ascertained the proportion avoidable. Indications for evisceration include intractable ocular infections, pthisis bulbi, an unsightly blind eye, and the need for prophylaxis against sympathetic ophthalmia following a globe rupture. The procedure is least likely to enhance the spread of infection from the eye to the cerebrospinal fluid.[4] Enucleation refers to the surgical removal of the eyeball from the orbit with severing of the optic nerve.[1] Indications include intraocular malignancy (e.g. retinoblastoma), a painful blind eye and unsightly blind eye.1`In order to achieve acceptable cosmetic outcome and symmetrical growth of the face, both enucleation and evisceration are usually accompanied by surgical placement of an orbital implant. Information obtained from this study will be used for further planning and implementation of promotive, preventive, curative and rehabilitative eye care services with an enhanced paediatric eye care being of import in this regard
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