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

Saad A. Al-Dahmash, Sawsan Saad Bakry, Nada H. Almadhi, Lolwah M. Alashgar

From the Department of Ophthalmology, College of Medicine,King Saud University, Riyadh, Saudi Arabia

How to cite this article:

Al-Dahmash SA, Bakry SS, Almahdi NH, Alashgar LM. Indications for enucleation and evisceration in a tertiary eye hospital in Riyadh over a 10-year period. Ann Saudi Med 2017; 37(4): 313-316.

DOI: 10.5144/0256-4947.2017.313


BACKGROUND: Enucleation and evisceration are eye removal procedures considered as palliative treatment when all other therapeutic options are exhausted.


OBJECTIVE: Describe the causes and histopathological findings leading to enucleation/evisceration, and correlate the clinical findings with the histopathological findings.


DESIGN: Retrospective, descriptive study.


SETTINGS: Tertiary care hospital, Riyadh, Saudi Arabia. 


PATIENTS AND METHODS: The 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. 


RESULTS: One 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%).


CONCLUSIONS: The 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.


LIMITATIONS: Retrospective study, in one hospital in one area; therefore, results cannot be generalized. 



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