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Miriam guadalupe arellano, Francisca Zuazo, Martin Gonzalez, ALBERTO ABDALA, Angel Nava, OSIRIS OLVERA-MORALES, JOSE LUIS TOVILLA CANALES; Characterization of patients receiving evisceration in a major metropolitan hospital in Mexico City. Invest. Ophthalmol. Vis. Sci. 2016;57(12):702.
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© ARVO (1962-2015); The Authors (2016-present)
Currently, evisceration is becoming a useful technique for the removal of the eye content in cases of endophthalmitis, painful blind eye, ocular trauma, among others. We performed a retrospective, observational clinical study to describe and analyze the causes, results and complications of evisceration surgery.
Clinical records of patients undergoing evisceration at Instituto de Oftalmología Conde de Valenciana IAP, between January 2008 and July 2015 were reviewed. Patients who underwent enucleation surgery or evisceration surgery performed in other institution, were excluded .We analyzed gender, age, operative eye, cause of evisceration, preoperative visual acuity, implant used, and complications.
A total of 186 eyes were eviscerated during the study period. 53% of the patients undergoing evisceration surgery, were men. The average age was 54 ± 23 years. The right eye was affected in 53% of cases. 79.2% of patients had a vision of No Light Perception in the affected eye and 92% of patients had preoperative pain.The mean preoperative intraocular pressure was 22.17 ± 15.6 mmHg. The most common diagnosis for which evisceration was performed, was endophthalmitis (28%), followed by ocular trauma in 23.12%. 10.8% of the operated eyes were reported to be in phthisis bulbi. In 86.8% of cases, a primary implant was placed. Of these, 34.1% were porous polyethylene. In 7.5% cases, a secondary implant was placed, approximately a month after evisceration surgery in cases of endophthalmitis. 4% of cases had implant extrusion, 75% of them being porous polyethylene. The ocular prosthesis was well tolerated in 91% of cases. Complications were present in 7.5%, being postoperative pain the most common. No cases of sympathetic ophthalmia were reported.
In our series, most of eviscerations were performed on the right eyes of men, with a vision of no light perception and preoperative pain. The main causes were endophthalmitis and ocular trauma. Most patients received a primary porous polyethylene implant, achieving good tolerance of the ocular prosthesis. Evisceration is shown as an alternative to enucleation in cases where the sclera can be preserved, showing low incidence of sympathetic ophthalmia. The importance of descriptive studies is that this data can serve as a prognostic indicator for patients that are candidates for this surgery.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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