Trends in Eye Removal Surgeries at a Tertiary Care Hospital Over Three Decades.

PURPOSE: To determine the trends in eye removal surgeries at a tertiary hospital in Nigeria over 26 years. METHODS: A retrospective comparative review of clinical records of all patients who had eye removal surgery at a tertiary hospital in Ile-Ife, Nigeria, between 2014 and 2019 was done. Patients' demographic and clinical data, including indication for eye removal and type of surgery were analysed and compared with two earlier studies at the same hospital between 1994 and 2013. RESULTS: There was an average of 14.3 surgeries per year between 2014 and 2019. Patients' ages ranged from 2 to 102 years, M:F was 1.5:1, the commonest indication for eye removal was infection (n=30, 34.9%), and the most common surgery was evisceration (n=70, 81.4%). Studies from 1994 to 2003 and 2005 to 2013, reported an average of 9.2 and 10 surgeries per year; ages ranging from 4 days to 88 years and 3 months to 88 years; with a M:F of 2.1:1 and 3.4:1 respectively. In both studies, the commonest indication for eye removal was trauma (43.4% and 43.8% respectively) and the most common surgery was enucleation (57.6% and 55% respectively). Trend data showed a progressive increase in eye infections (12% vs 15% vs 34.9%) and eviscerations (19.6% vs 31.2% vs 81.4%) over time. CONCLUSION: There was a change in trend towards an increase in eviscerations and infective indications for eye removal at the hospital over three decades. Prompt and optimal treatment of orbito-ocular infections is recommended to reduce the incidence of eye removal surgeries.

BUT: Déterminer les tendances des chirurgies d'ablation de l'oeil dans un hôpital tertiaire du Nigeria sur une période de 26 ans. MÉTHODES: Un examen comparatif rétrospectif des dossiers cliniques de tous les patients ayant subi une chirurgie d'ablation de l'œil dans un hôpital tertiaire d'Ile-Ife, au Nigeria, entre 2014 et 2019, a été effectué. Les données démographiques et cliniques des patients, y compris l'indication de l'ablation de l'œil et le type de chirurgie, ont été analysées et comparées à deux études antérieures menées dans le même hôpital entre 1994 et 2013. RÉSULTATS: Il y avait une moyenne de 14,3 chirurgies par an entre 2014 et 2019. L'âge des patients allait de 2 à 102 ans, le rapport M:F était de 1,5:1, l'indication la plus courante pour l'ablation de l'œil était l'infection (n=30, 34,9%), et la chirurgie la plus fréquente était l'éviscération (n=70, 81,4%). Les études menées de 1994 à 2003 et de 2005 à 2013 ont fait état d'une moyenne de 9,2 et 10 interventions chirurgicales par an, d'âges allant de 4 jours à 88 ans et de 3 mois à 88 ans, et d'un rapport M:F de 2,1:1 et 3,4:1 respectivement. Dans les deux études, l'indication la plus courante pour l'ablation de l'œil était le traumatisme (43,4 % et 43,8 % respectivement) et la chirurgie la plus courante était l'énucléation (57,6 % et 55 % respectivement). Les données sur les tendances ont montré une augmentation progressive des infections oculaires (12 % vs 15 % vs 34,9 %) et des éviscérations (19,6 % vs 31,2 % vs 81,4 %) au fil du temps. CONCLUSION: On constate un changement de tendance vers une augmentation des éviscérations et des indications infectieuses pour l'ablation des yeux à l'hôpital sur trois décennies. Un traitement rapide et optimal des infections orbitooculaires est recommandé pour réduire l'incidence des chirurgies d'ablation des yeux. Mots clés: Anesthésie, énucléation, éviscération, exentération, implant orbitaire, tendances.

Epidemiology and Management of Oculoplastic Disorders at a Tertiary Hospital: A 4-Year Review.

PURPOSE: To describe the epidemiology and management of oculoplastic disorders at a tertiary hospital in Nigeria. METHODS: This was a retrospective review of patients with oculoplastic disorders at the Department of Ophthalmology, Obafemi Awolowo University Teaching Hospitals Complex, IleIfe, Nigeria from January 2013 to December 2016. The general ophthalmology service records were reviewed to identify patients with oculoplastic disorders. Data retrieved from patient records included date of initial visit, age at presentation, gender, oculoplastic diagnosis and aetiology, modality of treatment given, and indications for patient referrals. RESULTS: There were 563 (7.4%) patients with oculoplastic disorders, out of 7,575 ophthalmology department patients. They had 573 oculoplastic disorders in all. There were 281 (49.9%) males and 282 (50.1%) females. The median age at presentation was 28 years (range, 1 day to 100 years). Eyelid laceration (n=68; 11.9%) and chalazion (n=63; 11%) were the commonest disorders. Trauma (n=125; 21.8%) was the commonest aetiology, followed by inflammatory (n=121; 21.1%) and infective (n=108; 18.8%) causes. There were 162 (28.3%) surgical interventions; eyelid repair (n=67; 41.4%) was the commonest, followed by evisceration (n=25; 15.4%), and excisional biopsy (n=25; 15.4%). No patient had ptosis or lacrimal surgery. Orbital disorders (n=21; 42.9%) were the commonest indication for a referral elsewhere. CONCLUSION: Eyelid laceration was the commonest oculoplastic disorder, trauma was the commonest aetiology, and eyelid repair was the commonest oculoplastic surgery done. Further training in oculoplastics with emphasis on ptosis, lacrimal and orbital surgery, as well as the provision of equipment needed for optimal oculoplastic service delivery are recommended.

OBJECTIF: Décrire l'épidémiologie et la gestion des troubles oculoplastiques dans un hôpital tertiaire du Nigeria. MÉTHODES: Il s'agissait d'un examen rétrospectif des patients atteints de troubles oculoplastiques au département d'ophtalmologie, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria, de janvier 2013 à décembre 2016. Les dossiers du service d'ophtalmologie générale ont été examinés afin d'identifier les patients souffrant de troubles oculoplastiques. Les données extraites des dossiers des patients comprenaient la date de la première visite, l'âge au moment de la présentation, le sexe, le diagnostic oculoplastique et l'étiologie, la modalité du traitement administré et les indications pour le renvoi des patients. RÉSULTATS: 563 (7,4 %) des 7 575 patients du service d'ophtalmologie présentaient des troubles oculoplastiques. Ils présentaient 573 troubles oculoplastiques au total. Il y avait 281 (49,9%) hommes et 282 (50,1%) femmes. L'âge médian à la présentation était de 28 ans (intervalle de 1 jour à 100 ans). Paupière (n=68 ; 11,9%) et le chalazion (n=63 ; 11%) étaient les troubles les plus courants. Le traumatisme (n=125 ; 21,8%) était l'étiologie la plus fréquente, suivie par les causes inflammatoires (n=121 ; 21,1%) et infectieuses (n=108 ; 18,8%). Il y a eu 162 (28,8 %) interventions chirurgicales ; la réparation de la paupière (n=67 ; 41,4 %) était la plus courante, suivie de l'éviscération (n=25 ; 15,4%) et de la biopsie excisionnelle (n=25 ; 15,4%). Aucun patient n'a subi de ptose ou de chirurgie lacrymale. Les troubles orbitaux (n=21 ; 42,9%) étaient l'indication la plus fréquente d'un renvoi ailleurs. CONCLUSION: La lacération de la paupière était le trouble oculoplastique le plus courant, le traumatisme était l'étiologie la plus courante et la réparation de la paupière était la chirurgie oculoplastique la plus courante. Il est recommandé de poursuivre la formation en oculoplastie en mettant l'accent sur le ptosis, la chirurgie lacrymale et orbitale, ainsi que de fournir l'équipement nécessaire à une prestation optimale des services oculoplastiques. Mots clés: Troubles oculoplastiques, prévalence, chirurgie, traumatisme.

Clinical Presentation and Treatment Outcome of Retinal Vein Occlusions in Ile Ife, Nigeria.

BACKGROUND AND OBJECTIVE: Retinal vein occlusion (RVO) is the second most common retinal vascular disease. This study aims to determine its clinical presentations, complications and treatment outcome in a Nigerian tertiary hospital. METHODS: The medical records of consecutive patients with RVO who presented to the vitreoretinal clinic of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife over a 5-year period were retrieved. Patients' demographic data, presenting visual acuity, retina examination (Volks +78D) findings, complications, treatment offered or given as well as the treatment outcome were extracted and analyzed using IBM Statistical Package for Social Sciences version 20.0 (IBM SPSS, Inc., Chicago, Illinois, USA) for Windows (Microsoft Corporation, Redmond, Washington, USA). RESULTS: Sixty-eight eyes of 63 patients had RVO giving a prevalence of 6.3%. Mean age was 65.5±8.0years, 38 (60.3%) were males and central retinal vein occlusion (CRVO) was the most common 46 (67.6%) type. Vision-threatening complication was present in 25(36.8%) eyes with macula oedema being the most common (76.0%). Twenty-three (36.5%) patients were scheduled for intravitreal pharmacotherapy and 2 referred for retina photocoagulation in another hospital. Sixteen eyes received intravitreal injections with 8 (50.0%) having improvement in vision, 3 (18.8%) had no change in visual acuity while 3 (18.8%) had their visual acuity reduced from baseline post injection. Two (12.4%) defaulted from follow up after the first dose of injection. CONCLUSION: Retinal vein occlusion is not of rare incidence with CRVO being the commonest type. Intravitreal pharmacotherapy plays a significant role in the treatment of vision loss from vision threatening complications.

Orbito-ocular soft tissue measurements in young adults--an indigenous Negro population study.

AIM: This study was named at determining normal orbital soft tissue parameters in young adults in an indigenous black population. METHODOLOGY: Prospective study on consentimg young adults in a Nigerian University with no previous orbito-facial trauma/surgery, strabismus, ptosis, telecanthus, and history of neurological diseases or previous ocular trauma were excluded. The age, sex and height of each participant were recorded. With the aid of a manual Sliding Vernier Caliper, the inner canthal distance (ICD), outer canthal distance (OCD), right horizontal palpebrae fissure length (RHPFL), left horizontal palpebrae fissure length (LHPFL). The results were imputed, analyzed and reported as simple frequency, means and standard deviations using the SPSS version 11 and statistical significant accepted at P < 0.05. RESULTS: Two hundred and four of participants of which 136 (66.7%) were males constituted the study population. Their ages ranged between 17-38 years with a mean and standard deviation of 23.6 ± 3.2 years. Their height ranged from 1.43-1.94 m with a mean and standard deviation of 1.70 ± 0.81 m. The mean and standard deviation for OCD, ICD, RHPFL and LHPFL were 99.6 ± 5.5 mm, 36.5 ± 3.3 mm, 32.5 ± 1.8 mm and 31.7 ± 1.9 mm, respectively. The range and mean ICD (28.2-45.4 mm and 36.5 mm) is greater than the range and mean palpebrae fissure lengths in either eye. Statistcally significant gender based differences were recorded in the mean OCD and ICD with higher values in in males. CONCLUSION: Normal soft tissue orbit-ocular parameters are presented for young adults in the population showing statistically significant mean larger values for males compared with female subjects.

Indication for eye removal in Ile-Ife, Nigeria.

The indication for surgical eye removal reflects the pattern of severe ocular diseases in a given community and gives insight into the causes of uniocular blindness. It is an unfortunate end to certain ocular morbidities. In instances where the fellow eye is already blind, it then becomes even more grievous. The aim of the study is to find out the reasons for surgical eye removal in Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC) Ile-Ife. Nigeria. Retrospective analytic study of records of all patients who had their eyes removed in the Ophthalmic theatre of OAUTHC Ile-Ife from January 1994 - December 2003 were reviewed without prejudice to method of such removal. A total of 94 eyes were removed during this 10 year period, out of which 92 records were available for inclusion in this study. 30.4% of the patients were below 10 years of age. The male to female ratio was 2.1:1. All cases of eye removal were uniocular. Trauma was the leading cause of eye removal (43.4%) while orbito-ocular tumour was next (30.4%). Tumour was the leading cause of eye removal in the paediatric age group (87.2%) with Retinoblastoma being the commonest indication. Six out of the 92 (6.5%) patients studied unfortunately were already blind in the second eye; in this group of individuals the reason for eye removal was preventable in 83.3%. Most of the indications for eye removal were avoidable. Eye health education is needful for the general populace and particularly for individuals with an 'only' eye.