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Salman J. Yousuf, Leslie S. Jones, Earl D. Kidwell, Jr; Indications and Complications of Orbital Eviscerations at Howard University Hospital. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1071.
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To determine the indications and complications of orbital eviscerations performed at a tertiary-care hospital in Washington, DC.
Medical records of patients who underwent orbital eviscerations between January 1995 and January 2010 were reviewed. Patient ethnicity, gender, age, indication for evisceration, most recent ophthalmic diagnosis, underlying cause, type and size of implant, complications of evisceration, need for subsequent surgery, and time to last follow-up were recorded.
Fifty-three eyes in 53 patients underwent orbital eviscerations; 96% were African-American, 62% were male, and the average patient age was 52 (+/-19) years old. Indications for evisceration were blind painful eye (83%), ocular disfigurement (11%), and failed repair of globe injury (6%). The most recent diagnoses prior to surgery were blind hypotensive eye (38%), blind hypertensive eye (34%), endophthalmitis (22%), and primary evisceration for globe injury (6%). Underlying diagnoses were trauma (50%), glaucoma (29%), chronic retinal ischemia (15%), and ocular infection (6%). Orbital implant exposure rate was 13% (median time to exposure following surgery was 4 months). Most implants were made of hydroxyapatite (70%) and the average size was 16 mm. Additional surgery was performed in 21% of patients; ptosis repair was the most common secondary surgery (13%). Infection was seen in 7.5% of patients (median time to infection following surgery was 13 months). Lower lid laxity, lagophthalmos, and fornix shortening were each seen in < 5% of patients. The average follow-up time was 15.7 months.
In our 15 year study, the majority of patients were African-American and most commonly underwent orbital evisceration for a blind painful eye, secondary to ocular trauma. End-stage glaucoma was more frequently an underlying cause than in previous studies. The most common complication was exposure of implant.
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