Enucleation and evisceration: 20 years of experience.
OBJECTIVE
To determine the indications, relative frequencies, surgical times, and complications for enucleation and evisceration performed at a single academic center.


METHODS
Medical records of all patients who underwent an enucleation or evisceration between January 1st, 1990 and December 31st, 2009 at a single academic center were reviewed. Patient demographics and surgical indications, times, and complications were recorded.


RESULTS
A total of 85 eyes in 85 patients underwent enucleation (n = 31; 36%) or evisceration (n = 54; 64%) during the study period. Almost all patients were of African descent (96%). The most common underlying cause leading to eye removal was trauma. On average, eviscerations (47.3 ± 10.3 minutes) took significantly less time to perform than enucleations (89.6 ± 10.1 minutes; p < 0.01). Complications included implant exposure, infection, lower lid laxity, fornix insufficiency, and need for subsequent surgery; the occurrence of these complications was found to be similar between the two groups (p = 0.77). No case of sympathetic ophthalmia or inadvertent evisceration of an eye with an occult intraocular malignancy was noted. From the first decade for which data were available (1990- 1999) to the second decade (2000- 2009), the average number of enucleations decreased (p = 0.02) and the average number of eviscerations (p = 0.04) increased.


CONCLUSIONS
Evisceration was found to be a safe and quicker alternative to enucleation in our study. A change in surgical preference from enucleation to evisceration was seen during the 20-year study period.
Department of Ophthalmology, Howard University, Washington, D.C., USA.
Salman J
SJ
Yousuf
Leslie S
LS
Jones
Earl D
ED
Kidwell
D001672:Biocompatible Materials; D044383:Black People; D017886:Durapatite; D005128:Eye Diseases / Q000208:ethnology / Q000601:surgery*; D015353:Eye Enucleation / Q000706:statistics & numerical data / Q000639:trends*; D017234:Eye Evisceration / Q000706:statistics & numerical data / Q000639:trends*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009885:Ophthalmology / Q000706:statistics & numerical data*; D009915:Orbit / Q000601:surgery; D020273:Orbital Implants; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D019919:Prosthesis Implantation; D013997:Time Factors
D001672:Biocompatible Materials; D017886:Durapatite