Gyasi M E, Amoaku W M, Adjuik M
Emmanuel Eye Centre, P.O. Box GP8967, Accra, Ghana.
Ghana Med J. 2009 Sep;43(3):122-6. doi: 10.4314/gmj.v43i3.55334.
To determine the causes and incidence of destructive ophthalmic procedures as seen at a major reference eye centre in northern Ghana
Retrospective case series involving a review of surgical records of all evisceration and enucleation procedures done between January 2002 and December 2006 at the Bawku Hospital Eye Department. Information collected included basic demographic data, diagnosis, visual acuity at diagnosis and the eye affected. The aetiology responsible was determined from history, clinical examination and investigations as contained in the existing records. The primary clinical indications for evisceration were categorized into degenerative lesions, infections, trauma, neoplasms, and others. Statistical analysis was done using the Epi Info software.
A total of 337 eyes of 336 patients made up of 217 (64.6%) males and 119 (35.4%) females were removed during the study period. Mean age was 36.4 with a range of 1-90 years. Children under 15 years constituted 25.1% of whom 9.3% were under 5 years. The elderly (>/=60 years) comprised 26.3%. The most common cause of destructive procedure was endophthalmitis /panophthalmitis (47.9%), ocular injuries (23.2%), degenerative lesions (8.9%) and neoplasms (5.1%). Regarding neoplasms, females were more likely to be enucleated while the reverse was so for traumas (p=0.04 and p=0.02, Chi(2) test, respectively). Compared to the total number of surgeries done each year the crude incidence was computed at 26.6% per 1000 cases per year.
Most causes of destructive procedures in this part of Ghana are preventable and serious preventive strategies are needed to reverse this trend.
确定在加纳北部一家主要的眼科转诊中心所见到的破坏性眼科手术的原因及发生率。
回顾性病例系列研究，涉及对2002年1月至2006年12月在巴库医院眼科进行的所有眼内容剜除术和眼球摘除术的手术记录进行审查。收集的信息包括基本人口统计学数据、诊断、诊断时的视力以及受累眼。根据现有记录中的病史、临床检查和检查结果确定病因。眼内容剜除术的主要临床指征分为退行性病变、感染、外伤、肿瘤及其他。使用Epi Info软件进行统计分析。
在研究期间，共摘除了336例患者的337只眼，其中男性217例（64.6%），女性119例（35.4%）。平均年龄为36.4岁，范围为1至90岁。15岁以下儿童占25.1%，其中5岁以下儿童占9.3%。老年人（≥60岁）占26.3%。破坏性手术最常见的原因是眼内炎/全眼球炎（47.9%）、眼外伤（23.2%）、退行性病变（8.9%）和肿瘤（5.1%）。关于肿瘤，女性更有可能接受眼球摘除术，而外伤则相反（分别为χ²检验，p = 0.04和p = 0.02）。与每年进行的手术总数相比，粗略发病率计算为每年每1000例中有26.6%。
加纳这一地区大多数破坏性手术的原因是可以预防的，需要采取严肃的预防策略来扭转这一趋势。
