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Vinicius Carriero Lima, Gabriela Cavalieri, Ana Beatriz Toledo Dias, Christina Mastromonaco, Sabrina Bergeron, Julia Burnier, Miguel N Burnier; Clinicopathological evaluation of eye removal procedures: a 13-year evaluation. Invest. Ophthalmol. Vis. Sci. 2019;60(9):713.
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© ARVO (1962-2015); The Authors (2016-present)
Eye removal to treat complicated ocular diseases can be associated with decreased quality of life and psychosocial issues. Evisceration, enucleation and exenteration represent the three main surgical techniques. Clinicopathological correlation is essential to reach a final diagnosis. The aim of this study is to correlate eye removal techniques with the clinical and the histopathological diagnosis.
Patients who underwent ocular removal were evaluated (2006-2018) at the MUHC-McGill University Ocular Pathology & Translational Research Laboratory. Specimens were stained with H&E. Immunohistochemistry/special stains were done in selected cases. Age, gender, type of surgery, clinical diagnosis and histopathological findings was collected.
A total of 242 specimens were examined. The average age was 59.24±21.26 years and patients over 40 years represented 78.51%. Evisceration was the most common type of surgery (54.13%), followed by enucleation (43.39%) and exenteration (2.48%). The age group of 61-80 years represented the majority of cases of exenteration (66.67%). Both evisceration and enucleation were more frequent in men than in women (53.44%and 60.95%, respectively). Regarding clinical diagnosis, a large number of surgical eye removal were due to inflammation/infection processes (n=89, 36.78%), followed by trauma (n=52, 21.07%). Trauma occurred more commonly in men (61.54%). In patients 0-20 years of age, the majority of surgeries were due to intraocular tumors (62.50%). Ocular infectious/inflammation were more frequent than trauma only in patients over 60 years of age. The diagnosis of blind painful eye was highest (41.18%) in patients aged 61-80 years.Chronic inflammation was the most common histopathological diagnosis (58.26%). Exenteration was performed most frequently as a result of neoplasia (83.33%), followed by chronic inflammation (67.18%).
Our study shows a large number of eviscerations in older patients with a clinical diagnosis of infection/inflammatory processes and chronic inflammatory histopathological findings. The majority of enucleation in children was due to retinoblastoma. Sebaceous cell carcinoma was responsible for most of the exenteration specimens. Clinicopathological studies are essential to evaluate eye removal disease and to predict clinical outcomes.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
Different types of surgery and clinical diagnosis according to age groups
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