Clinical Characteristics and Outcomes in Patients Undergoing Primary or Secondary Enucleation or Evisceration After Ocular Trauma

Angela C Gauthier, Oluseye K Oduyale, Michael J Fliotsos, Sidra Zafar, Nicholas R Mahoney, Divya Srikumaran, Fasika A Woreta Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USACorrespondence: Fasika A WoretaWilmer Eye Institute, Johns Hopkins School of Medicine 600 North Wolfe...

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Autores principales:	Gauthier AC, Oduyale OK, Fliotsos MJ, Zafar S, Mahoney NR, Srikumaran D, Woreta FA
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	evisceration enucleation open globe repair traumatic eye injury Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/f356efefc3d8445096b41f708db0ba07
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spelling	oai:doaj.org-article:f356efefc3d8445096b41f708db0ba072021-12-02T10:20:37ZClinical Characteristics and Outcomes in Patients Undergoing Primary or Secondary Enucleation or Evisceration After Ocular Trauma1177-5483https://doaj.org/article/f356efefc3d8445096b41f708db0ba072020-10-01T00:00:00Zhttps://www.dovepress.com/clinical-characteristics-and-outcomes-in-patients-undergoing-primary-o-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Angela C Gauthier, Oluseye K Oduyale, Michael J Fliotsos, Sidra Zafar, Nicholas R Mahoney, Divya Srikumaran, Fasika A Woreta Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USACorrespondence: Fasika A WoretaWilmer Eye Institute, Johns Hopkins School of Medicine 600 North Wolfe Street, Baltimore, MD 21205, USATel +1 410-961-2868Fax +1 410-614-9632Email fworeta1@jhmi.eduPurpose: To investigate the frequency of primary versus secondary eye removal, frequency of enucleation versus evisceration, and characteristics and outcomes of patients undergoing these procedures after presenting with severe ocular trauma.Patients and Methods: Retrospective chart review of patients presenting to the emergency department (ED) with severe eye trauma necessitating enucleation or evisceration between 2010 and 2018.Results: There were 92 eyes from 90 patients included in our study. Twenty-seven percent of eyes underwent primary removal (n=25, 14 enucleation, 11 evisceration), while 73% of eyes underwent secondary removal (n=67, 50 enucleation, 17 evisceration). The mean patient age was 45.2 years (range 4.2– 92.6); primary enucleation/evisceration patients were older on average than secondary eye removal patients [53.8 years (range 15.9– 91.2) versus 42.2 years (range 4.2– 91.6 years), p=0.04]. A median of 34 days passed between ED presentation and secondary enucleation/evisceration. Before undergoing secondary enucleation/evisceration, patients underwent a median of one ocular procedure (range 0– 14) for various complications of trauma including orbital infection, choroidal or retinal tear or detachment, and wound dehiscence. Open globe injury repairs comprised 43 of the 92 total procedures (47%) performed prior to secondary enucleation/evisceration. Secondary enucleations/eviscerations required a median of seven clinic visits compared to two clinic visits required after primary surgeries (p< 0.01). 10.7% of all patients (n=10) had at least one implant-related complication following enucleation/evisceration, with all but one of these patients being in the secondary enucleation/evisceration group.Conclusion: Primary enucleation or evisceration was performed in 27% of all eye removals, and enucleation was performed in 69.6% of all eye removals. Future research is warranted to determine if primary eye removal may be appropriate and when to consider enucleation versus evisceration.Keywords: evisceration, enucleation, open globe repair, traumatic eye injuryGauthier ACOduyale OKFliotsos MJZafar SMahoney NRSrikumaran DWoreta FADove Medical Pressarticleeviscerationenucleationopen globe repairtraumatic eye injuryOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 3499-3506 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	evisceration enucleation open globe repair traumatic eye injury Ophthalmology RE1-994
spellingShingle	evisceration enucleation open globe repair traumatic eye injury Ophthalmology RE1-994 Gauthier AC Oduyale OK Fliotsos MJ Zafar S Mahoney NR Srikumaran D Woreta FA Clinical Characteristics and Outcomes in Patients Undergoing Primary or Secondary Enucleation or Evisceration After Ocular Trauma
description	Angela C Gauthier, Oluseye K Oduyale, Michael J Fliotsos, Sidra Zafar, Nicholas R Mahoney, Divya Srikumaran, Fasika A Woreta Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USACorrespondence: Fasika A WoretaWilmer Eye Institute, Johns Hopkins School of Medicine 600 North Wolfe Street, Baltimore, MD 21205, USATel +1 410-961-2868Fax +1 410-614-9632Email fworeta1@jhmi.eduPurpose: To investigate the frequency of primary versus secondary eye removal, frequency of enucleation versus evisceration, and characteristics and outcomes of patients undergoing these procedures after presenting with severe ocular trauma.Patients and Methods: Retrospective chart review of patients presenting to the emergency department (ED) with severe eye trauma necessitating enucleation or evisceration between 2010 and 2018.Results: There were 92 eyes from 90 patients included in our study. Twenty-seven percent of eyes underwent primary removal (n=25, 14 enucleation, 11 evisceration), while 73% of eyes underwent secondary removal (n=67, 50 enucleation, 17 evisceration). The mean patient age was 45.2 years (range 4.2– 92.6); primary enucleation/evisceration patients were older on average than secondary eye removal patients [53.8 years (range 15.9– 91.2) versus 42.2 years (range 4.2– 91.6 years), p=0.04]. A median of 34 days passed between ED presentation and secondary enucleation/evisceration. Before undergoing secondary enucleation/evisceration, patients underwent a median of one ocular procedure (range 0– 14) for various complications of trauma including orbital infection, choroidal or retinal tear or detachment, and wound dehiscence. Open globe injury repairs comprised 43 of the 92 total procedures (47%) performed prior to secondary enucleation/evisceration. Secondary enucleations/eviscerations required a median of seven clinic visits compared to two clinic visits required after primary surgeries (p< 0.01). 10.7% of all patients (n=10) had at least one implant-related complication following enucleation/evisceration, with all but one of these patients being in the secondary enucleation/evisceration group.Conclusion: Primary enucleation or evisceration was performed in 27% of all eye removals, and enucleation was performed in 69.6% of all eye removals. Future research is warranted to determine if primary eye removal may be appropriate and when to consider enucleation versus evisceration.Keywords: evisceration, enucleation, open globe repair, traumatic eye injury
format	article
author	Gauthier AC Oduyale OK Fliotsos MJ Zafar S Mahoney NR Srikumaran D Woreta FA
author_facet	Gauthier AC Oduyale OK Fliotsos MJ Zafar S Mahoney NR Srikumaran D Woreta FA
author_sort	Gauthier AC
title	Clinical Characteristics and Outcomes in Patients Undergoing Primary or Secondary Enucleation or Evisceration After Ocular Trauma
title_short	Clinical Characteristics and Outcomes in Patients Undergoing Primary or Secondary Enucleation or Evisceration After Ocular Trauma
title_full	Clinical Characteristics and Outcomes in Patients Undergoing Primary or Secondary Enucleation or Evisceration After Ocular Trauma
title_fullStr	Clinical Characteristics and Outcomes in Patients Undergoing Primary or Secondary Enucleation or Evisceration After Ocular Trauma
title_full_unstemmed	Clinical Characteristics and Outcomes in Patients Undergoing Primary or Secondary Enucleation or Evisceration After Ocular Trauma
title_sort	clinical characteristics and outcomes in patients undergoing primary or secondary enucleation or evisceration after ocular trauma
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/f356efefc3d8445096b41f708db0ba07
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Clinical Characteristics and Outcomes in Patients Undergoing Primary or Secondary Enucleation or Evisceration After Ocular Trauma

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