Indications for enucleation and evisceration in a tertiary eye hospital in Riyadh over a 10-year period.

Abstract

BACKGROUNDEnucleation and evisceration are eye removal procedures considered as palliative treatment when all other therapeutic options are exhausted.OBJECTIVEDescribe the causes and histopathological findings leading to enucleation/evisceration, and correlate the clinical findings with the histopathological findings.DESIGNRetrospective, descriptive study.SETTINGSTertiary care hospital, Riyadh, Saudi Arabia.PATIENTS AND METHODSThe medical records of patients who underwent enucleation or evisceration from February 2005 to May 2015 were reviewed. Patients were classified into two categories based on indications of surgery: traumatic and nontraumatic. Causes of ocular injury in the traumatic group were documented, and the histopathological findings were reviewed for the nontraumatic cases.MAIN OUTCOME MEASURE(S)Number of enucleation and evisceration surgeries and their causes and histopathological findings.RESULTSOne hundred ten patients underwent evisceration (n=69, 63%) and enucleation (n=41, 37%). Causes were traumatic in 38 (35%) and nontraumatic in 72 (65%). The median age was 50 years and there were 64 men and 46 women. Postoperative endophthalmitis was the most common indication for surgery (n=24, 21.8%), followed by painful blind eye (n=22, 20%). Ocular trauma was more predominant in men (n=29, 76%) than in women (n=9, 24%), and the leading mechanism of trauma was metallic nail injuries (n= 6, 15.8%). In the nontraumatic group, endophthalmitis was the most common histopathological finding (n= 25, 34.7%).CONCLUSIONSThe majority of the eye enucleation/evisceration surgeries were due to nontraumatic causes, especially postoperative infections. However, severe eye trauma was still a main indication for this destructive procedure. Guidelines are needed to decrease the incidence/severity of work-related eye injuries and to detect and manage eye infections earlier and more promptly.LIMITATIONSRetrospective study, in one hospital in one area; therefore, results cannot be generalized.