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      Indications for ocular evisceration and orbital implant related complications in a tertiary eye hospital in Hungary over an 11-year period

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          Abstract

          Purpose

          Our aims were to evaluate the primary and clinical evisceration indications and to analyse orbital implant related complications.

          Materials/methods

          We included in our retrospective review all eviscerations between 2006 and 2016 at the Department of Ophthalmology of Semmelweis University, Budapest, Hungary. Primary evisceration indications were classified into six groups: trauma, surgical diseases, infections or inflammations, systemic diseases, tumours and unclassifiable diseases. Clinical immediate evisceration indications were also classified into six groups: painful blind eye due to glaucoma, atrophia/phthisis bulbi, endophthalmitis, cosmetic reasons, acute trauma and expulsive bleeding.

          Results

          Evisceration was performed in 46 eyes of 46 patients (54.3% males, age 43.0 ± 18.6 years). The most common primary evisceration indications were trauma (37%), surgical diseases (34.8%), infection or inflammation (10.9%), systemic diseases (6.5%), tumours (8.7%) and unclassifiable diseases (2.2%). Painful blind eye due to glaucoma (34.8%) was the most common clinical indication for evisceration, followed by atrophia/phthisis bulbi (26.1%), endophthalmitis (17.4%), cosmetic reasons (13.0%), acute trauma (6.5%) and expulsive bleeding (2.2%). After evisceration, 91.3% of the patients received orbital implant and during 26.8±28.9 months follow-up implant related complications were found in 14.3% of the cases, including implant extrusion (4.8%), partial wound dehiscence (4.8%), implant exposure (2.4%) and orbital inflammation (2.4%).

          Conclusion

          Painful blind eye and atrophia/phthisis bulbi due to ocular trauma and surgical diseases represent the most common indications for ocular evisceration. If malignant intraocular tumours can be excluded, evisceration surgery combined with a silicon-based orbital implant is a safe and effective procedure.

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          Most cited references21

          • Record: found
          • Abstract: found
          • Article: not found

          Enucleation and evisceration: 20 years of experience.

          To determine the indications, relative frequencies, surgical times, and complications for enucleation and evisceration performed at a single academic center.
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            • Record: found
            • Abstract: found
            • Article: not found

            Review of 1375 enucleations in the TongRen Eye Centre, Beijing.

            To review clinical causes for ocular enucleations and the histopathological features of the enucleated globes in a large third-referral centre in China. The retrospective study included 1375 globes enucleated in the Beijing TongRen Hospital between January 2003 and November 2006. The medical records were reviewed, and the clinical indications for enucleation and histopathological findings were evaluated. The enucleated eyes accounted for 0.97% of all operated patients registered in the hospital and for 29.5% of all surgical specimens received in the pathological department. The age distribution showed two peaks at an age group of 0-10 years (main enucleation cause: retinoblastoma) and at an age group of 30-40 years (main cause: trauma). In the whole study group, trauma was the most common clinical diagnosis (62.5%) leading to enucleation, followed by tumours (28.5%), surgically treated or untreated ocular diseases (5.7%), and infectious or inflammatory diseases (1.7%). With respect to the histopathological findings, phthisis bulbi (36.4%) was the most frequent finding followed by ocular malignant tumours (28.5%), and acute severe ocular injury (19.9%). Uveal metastases were the second most common intraocular malignant tumour in adults, in the majority of globes secondary to a primary lung cancer. The rate of 1% of enucleations per patient operated and the relatively high rate of ocular traumata as primary cause for enucleation suggest to improve further safety conditions and primary surgical care. The relatively high rate of ocular tumours as cause for enucleations suggests to promote the wide-spread clinical introduction of chemoradioactive tumour therapy.
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              • Record: found
              • Abstract: found
              • Article: not found

              Enucleation versus evisceration in ocular trauma: a retrospective review and study of current literature.

              To compare variables and outcomes from ocular trauma leading to either enucleation or evisceration to better inform surgical decision making.
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                Author and article information

                Contributors
                Journal
                2066
                Developments in Health Sciences
                DHS
                Akadémiai Kiadó (Budapest )
                2630-9378
                2630-936X
                18 November 2020
                Affiliations
                [1 ] Department of Ophthalmology, Semmelweis University , Budapest, Hungary
                [2 ] Department of Ophthalmology, Saarland University Medical Center, UKS , Homburg, Saar, Germany
                [3 ] Department of Ophthalmology, Bajcsy-Zsilinszky Hospital , Budapest, Hungary
                [4 ] Faculty of Health Sciences, Semmelweis University , Budapest, Hungary
                Author notes
                [* ]Corresponding author. Department of Ophthalmology Semmelweis University Mária utca 39. Budapest, H-1085, Hungary. E-mail: gabortothgabor@ 123456gmail.com
                Article
                10.1556/2066.2020.00008
                48aea0e3-513b-4c1b-a8c3-aee8325e29ef
                © 2020 The Author(s)

                Open Access. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited, a link to the CC License is provided, and changes – if any – are indicated. (SID_1)

                History
                : 30 April 2020
                : 4 June 2020
                : 12 June 2020
                Page count
                Figures: 4, Equations: 0, References: 21, Pages: 05
                Categories
                Original Research Paper
                Custom metadata
                1

                Medicine,Immunology,Health & Social care,Microbiology & Virology,Infectious disease & Microbiology
                complication,anophthalmic surgery,orbital implant,evisceration

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