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Adam Sweeney, Aaron Y. Lee, Eissa Hanna; Ophthalmic surgical interventions following open globe repair in patients ultimately requiring enucleation. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2312.
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Following open globe repair (OGR), a minority of eyes undergo multiple surgeries with some ultimately requiring enucleation. The number and type of surgeries performed after OGR, however, is not well established. We performed a retrospective review seeking to describe the surgical interventions utilized before and after enucleation in patient eyes with initial OGR.
In this retrospective study, we evaluated all patients who underwent enucleation after OGR over a thirteen-year period (2002-2015) at a tertiary referral center. Exclusion criteria were lack of operative records, patients less than 18 years of age, and patients with aborted OGR or conversion to primary enucleation. Patients meeting the study criteria were evaluated for time between OGR and enucleation, surgeries performed prior to enucleation, and surgeries performed after enucleation.
One hundred and forty-five patients underwent enucleation following OGR over the study period. The mean time between OGR and enucleation was 92 days (SD 365, range 2-3110). The median followup after enucleation was 85.5 days (SD 965, range 1-5285). Enucleation was the only surgery performed after OGR in 119 patients (82%). Eleven patients (8%) underwent at least one procedure prior to enucleation after OGR including pars plana vitrectomy (N=8), soft tissue reconstruction (N=2), and corneal laceration revision (N=1). Following enucleation after OGR, 19 patients required oculoplastic procedures including orbit/implant reconstruction (N=8), eyelid/soft tissue repair (N=7), or lacrimal drainage surgery (N=4). The incidence of oculoplastic surgery after enucleation increased substantially over longer followup, as seen on a Kaplan-Meier plot (figure 1).
Our study suggests that following OGR, it was rare for patients who ultimately received enucleation to have undergone further surgeries in attempt to save the eye. The most common procedures performed in this patient group after OGR were vitreoretinal and oculoplastic procedures. The rate of oculoplastic intervention following enucleation after OGR may suggest considerable complexities with enucleation in this patient population warranting extensive followup.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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