Enucleation versus Evisceration in Ocular Trauma: A Retrospective Review and Study of Current Literature

Background:We investigated the contributing causes and factors leading to eye enucleation procedure among the patients referred to the ophthalmology clinic of the Center Eye Hospital in Tehran, Iran.Patients and Methods:We retrospectively analyzed the clinical records of patients referred to the ophthalmology clinic of the Center Eye Hospital in Tehran, Iran, in the past 3 years. The data retrieved were analyzed.Results:A total of 313 patients underwent eye enucleation during the past 3 years. The average age of the patients was 36.7 years (range: 20–44 years). Two hundred and eight patients (66.5%) were males and 105 (33.5%) were females. One hundred and sixty-nine patients had the right eye enucleation while 144 patients had the left eye enucleation. The various procedures included enucleation (83%), evisceration (13.4%), and exantration (3.6%). The factors leading to these procedures included trauma (33.2%), phthisis bulbi (20.7%), tumors (15.7%), and infections (10.5%).Conclusion:In our study population, trauma was the main factor leading to eye enucleation. Hence, measures to increase social awareness and knowledge to reduce trauma cases are necessary as a preventive approach to reduce eye enucleation procedures. Concurrently, ophthalmologists should also pay more attention in early diagnoses and screening of eye health, especially detecting tumor cases such as retinoblastoma and postsurgical care to reduce secondary infections will be effective actions to reduce the overall rate of enucleation.

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“…Such higher incidence among men is previously reported from several other geographical regions. [678910111213]…”

Section: Discussionmentioning

confidence: 99%

“…Overall, 83.4% of the surgeries were enucleation, 13.4% were evisceration, and 3.2% were exantration, which is consistent with the previous reports. [357] Contradicting this, other studies have reported evisceration as the major surgical approach. [89]…”

Section: Discussionmentioning

confidence: 99%

Common causes of eye enucleation among patients

et al. 2017

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“…According to the 2001–2010 report by the Trauma Center, at University Hospital, Newark, New Jersey, 6.0% of 183 work-related injured eyes underwent enucleation, 45 and 45.9% of 148 assault-related injured eyes with NLP and 31.1% received enucleation 46 . According to the 2001–2012 report of the Trauma Center in Queens, New York, there were 441 cases of eye injuries, with the enucleation rate of 5.0% 47 . By comparing with the high rate in the Trauma Center, University Hospital, we can find that China has made remarkable achievement in the education and medical treatment for eye injuries in recent years.…”

Section: Comprehensive Development Of Medical Treatment For Eye Injurmentioning

confidence: 99%

Development of medical treatment for eye injuries in the mainland of China over the past decade

Wang

2016

Chinese Journal of Traumatology

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In the article, the development of medical treatment for eye injuries in the mainland of China was reviewed. According to the data provided in Eye Injury Vitrectomy Study (EIVS), 27% of 72 eyes with no light perception (NLP) gained recovery in term of antomy and visual function. Vitrectomy initiated at more than 4 weeks after open eye injury is an independent risk factor for developing PVR. Prognosis of anatomy and visual function of the injured eye with PVR is markedly worse than that without PVR. Serious injuries of ciliary body, choroid and retina are three key parts of the eye with NLP. The concept that the treatment of the eye injury gradually focus on the whole globe is embodied. The data from 13575 in patients with traumatic eyes in 14 hospitals revealed that the rate of immediate enucleation was remarkable reduced with comparison of 20 years ago.

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“…[6][7][8] Three ocular-orbital-palpebral surgeries are related to ocular bulb removal: evisceration, comprising the partial removal of the ocular bulb with conservation of the sclera; enucleation, comprising the total removal of the bulb with only the capsule and oculomotor muscles remaining; and exenteration, comprising the removal of all contents of the orbital cavity and the circumjacent tissue. [9][10][11][12][13][14] To rehabilitate patients with deformities of the ocular bulb, an ocular prosthesis may be used. [15][16][17][18][19][20] Prosthesis use improves the patient's aesthetic appearance, helping their psychosocial development and improving their quality of life.…”

mentioning

confidence: 99%

“…related to the presence of other muscles in the upper part, such as the levator palpebrae superioris, which is normally preserved in the anophthalmic cavity after enucleation of the ocular bulb, [9][10][11][12][13] aiding the movement of the future prosthesis.…”

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confidence: 99%