Enucleation and evisceration: An analysis of indications, histopathological findings and surgical trends over 23 years
What:
Paper Presentation | Présentation d'article
Part of:
When:
2:40 PM, Friday 1 Jun 2018
(6 minutes)
Where:
Metro Toronto Convention Centre (South Building)
- Room 714 A
How:
Authors: Kelsey A. Roelofs, Helya Aghazadeh, Marvi Cheema, Ezekiel Weis, Jaime Badilla
Author Disclosure Block: K.A. Roelofs: None. H. Aghazadeh: None. M. Cheema: None. E. Weis: None. J. Badilla: None.
Abstract Body:
Purpose: To report indications for eye removal, histopathological diagnosis and surgical trends in enucleation versus evisceration over a 23-year period.
Study Design: Retrospective consecutive case series of patients undergoing enucleation or evisceration at our institution.
Methods: Ethics approval was obtained from the University of Alberta Health Research Ethics board. An electronic database containing all operative slates for all ophthalmic surgeries performed at the Royal Alexandra Hospital in Edmonton, Canada, was searched for records of all enucleations or eviscerations performed between January 1994 and December 2016. A total of 786 cases were identified. Basic demographic information, including gender, date of birth, operative date and laterality were recorded. Archived hospital charts were accessed and reviewed for clinical and histopathological diagnoses as well as the type of implant used. Univariate and multivariate logistic regression analysis was performed to determine which variables were associated with enucleation vs evisceration and to calculate corresponding odds ratios. The study cohort was divided into two time periods by separating the first 10 years of the study period (1994- 2004 inclusive) from the rest of the study time period (2005-2016 inclusive).
Results: A total of 786 patients with a mean age (±SD) of 52 years ± 23 years were included. The most common clinical diagnosis was blind painful eye (56%) followed by intraocular tumor (23%). Corresponding pathological examination of specimens revealed chronic inflammatory change (46%) and intraocular tumor (25%). Eyes with active infection were more likely to be eviscerated (OR: 4.67; p<0.001) when compared to other diagnostic groups, and all eyes diagnosed with intraocular tumors were enucleated. While most eyes in the study were enucleated, the proportion of eyes eviscerated increased over the study period (p=0.010) from 8% between 1994-2004 to 14% between 2005-2016.
Conclusions: While enucleation was performed more commonly overall, the incidence of evisceration increased throughout the study period. The proportion of patients that underwent evisceration was the highest in cases of infection and in older patients. In our series, there were no instances of occult intraocular tumor in patients who were eviscerated, suggesting that in cases where careful pre-operative ultrasonography is performed by a skilled physician, evisceration may be a safe option for eye removal.
Author Disclosure Block: K.A. Roelofs: None. H. Aghazadeh: None. M. Cheema: None. E. Weis: None. J. Badilla: None.
Abstract Body:
Purpose: To report indications for eye removal, histopathological diagnosis and surgical trends in enucleation versus evisceration over a 23-year period.
Study Design: Retrospective consecutive case series of patients undergoing enucleation or evisceration at our institution.
Methods: Ethics approval was obtained from the University of Alberta Health Research Ethics board. An electronic database containing all operative slates for all ophthalmic surgeries performed at the Royal Alexandra Hospital in Edmonton, Canada, was searched for records of all enucleations or eviscerations performed between January 1994 and December 2016. A total of 786 cases were identified. Basic demographic information, including gender, date of birth, operative date and laterality were recorded. Archived hospital charts were accessed and reviewed for clinical and histopathological diagnoses as well as the type of implant used. Univariate and multivariate logistic regression analysis was performed to determine which variables were associated with enucleation vs evisceration and to calculate corresponding odds ratios. The study cohort was divided into two time periods by separating the first 10 years of the study period (1994- 2004 inclusive) from the rest of the study time period (2005-2016 inclusive).
Results: A total of 786 patients with a mean age (±SD) of 52 years ± 23 years were included. The most common clinical diagnosis was blind painful eye (56%) followed by intraocular tumor (23%). Corresponding pathological examination of specimens revealed chronic inflammatory change (46%) and intraocular tumor (25%). Eyes with active infection were more likely to be eviscerated (OR: 4.67; p<0.001) when compared to other diagnostic groups, and all eyes diagnosed with intraocular tumors were enucleated. While most eyes in the study were enucleated, the proportion of eyes eviscerated increased over the study period (p=0.010) from 8% between 1994-2004 to 14% between 2005-2016.
Conclusions: While enucleation was performed more commonly overall, the incidence of evisceration increased throughout the study period. The proportion of patients that underwent evisceration was the highest in cases of infection and in older patients. In our series, there were no instances of occult intraocular tumor in patients who were eviscerated, suggesting that in cases where careful pre-operative ultrasonography is performed by a skilled physician, evisceration may be a safe option for eye removal.
