Indications for destructive eye surgeries among adults in a tertiary eye care center in North CENTRAL Nigeria.

BACKGROUND

Destructive eye surgery is a management option offered patients when further retention of the globe is likely to affect ocular and general health or jeopardize survival. Indications for this procedure vary and could reflect the pattern of severe or end stage ocular morbidities in a given environment.

AIM

To assess the indications for destructive eye surgeries and to ascertain the proportion avoidable.

SETTING

Jos University Teaching Hospital, Jos, Nigeria.

METHODOLOGY

The ophthalmic surgical database of our facility was retrospectively reviewed to obtain information on patients who had destructive eye surgery from January 2008 - December 2015. These included demographics, clinical features, preoperative diagnosis, indication for surgery and type of destructive eye surgeries. The total number of ophthalmic surgeries within the study period was also computed. The data was entered into Epi Info statistical software, version3.4 (Epi InfoTM, Atlanta, Georgia,USA) and analyzed after validation by double entry.

RESULTS

Eighty five destructive eye surgeries consisting of 2.5% of all surgical operations were performed on adults (aged ≥18years). There were 51(60%) males with a male: female ratio of 1.5:1 (p<0.005), mean age of 46.4 ± 19years. A sustained decline in the proportion of surgeries attributable to destructive eye surgeries was observed from the year 2012. A total of 75(88.2%) patients had evisceration, 3(3.5%) had enucleation and 7(8.2%) had exenteration. The main indications for destructive eye surgeries included trauma to the eyes in 39(45.9%), intractable infections in 32(37.6%), tumours in 7(8.2%) and painful blind eye in 3(3.5%); anterior staphyloma and phthisis bulbi each accounted for 2(2.4%). We observed that an adult male was four times more likely to lose an eye from trauma than a female (p<0.05). An individual was less likely to lose an eye to trauma with increasing age (p<0.05) but more likely to lose an eye to intractable infection with increasing age (p<0.001).

CONCLUSION

There is a downtrend in the frequency of destructive eye surgeries in our center with males more likely to lose an eye to trauma and the elderly more likely to lose an eye to infection. Most of the indications for eye removal are avoidable.