Abstract
Purpose: :
To determine the most common indications of enucleation and evisceration and to determine the incidence and frequency of the different complications of enucleation and evisceration surgery
Methods: :
Clinical and surgical records were reviewed of all patients who underwent enucleation or evisceration at a single medical center between January 1, 1998 and December 31, 2007.
Results: :
Of the 8,425 major surgeries performed at LSUHSC-Shreveport from January 1, 1998 to December 31, 2007, enucleation comprised 1.32% (112/8425) and evisceration 0.08% (7/8425). Most cases for enucleation were due to a ruptured globe, phthisis bulbi, end-stage glaucoma and suspected malignancy. There were 225 cases of open globe managed at LSUHSC-Shreveport from January 1, 1998 to December 31, 2007 with 5 cases of primary enucleation surgery performed secondary to extensive corneoscleral rupture. Eviscerations were due to endophthalmilitis or extensive corneal graft dehiscence from trauma, with one case of encephalomacia of the frontal lobe. Majority of the surgeries involved the use of sclera-wrapped hydroxyapatite implant or medpor implant with only 2 cases where a PMMA sphere was used. Among the enucleation surgeries done, there is one incidence of prosthesis malposition requiring inferior fornix reconstruction 4 months from enucleation; one incidence of implant exposure 6 months from enucleation managed with a scleral patch graft; one incidence of extrusion 4 years after enucleation and one incidence of implant exposure with concomitant conjunctival infection one month from the original surgery. There was no case of sympathetic ophthalmia from review of the open globe cases.
Keywords: trauma • orbit • wound healing