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.

Adolescent and adult cleft lip and palate, in Ile-Ife, Nigeria.

INTRODUCTION: Congenital cleft lip and palate (CLP) defects usually present in childhood, especially in places with available and affordable care. In Nigeria, their incidence is low but late presentation in Adult life have been reported. This article aims at reviewing adolescent and adult CLP patients in our center, with the advent of free and available care, and to document the patterns and management outcomes of these patients as an addition to existing literature on the subject of adult CLP. MATERIALS AND METHODS: A retrospective review of adolescent and adult CLP patients managed from May 2006 to April 2010. Demographic data as well as clinical information were retrieved from the hospital records and include the type of cleft deformity, surgical intervention prior to presentation, the type of surgery performed and postoperative outcomes. Some pertinent clinical photos were also reviewed. RESULTS: Adolescent and adults constituted 24% of the 137 patients, their age ranged from 13 to 76 years, with a mean, median and modal age of 28, 22 and 20 years respectively. Unilateral cleft of primary palate was commonest with female preponderance. Most never had surgery, others desired revision surgery or secondary procedures. The outcomes were satisfactory in the 37 procedures performed on 33 patients. CONCLUSION: A relatively high ratio of adolescent and adult clefts is observed. Most of them have never had surgical intervention. Some had failed surgical intervention prior to presentation. Satisfactory outcomes were achieved despite late intervention but failed initial intervention was associated with poorer outcomes.

Behavioural biting preference of Culex quinquefasciatus in human host in Lagos metropolis Nigeria.

BACKGROUND & OBJECTIVES: Olfactory cues play an important role in the attraction of major disease vectors towards their host. Hence we intend to investigate the contribution of selected parts of the human host on the behavioural biting preference of Culex quinquefasciatus. METHODS: Two volunteers were trained to collect host seeking female mosquitoes landing to feed on different parts of the lower limbs. The Cx. quinquefasciatus were collected in paper cups with the aid of a flash-light and aspirator. Each paper cup was labeled to represent the selected parts where the mosquitoes were collected. RESULTS: The composition of Cx. quinquefasciatus from the total mosquitoes collected showed that Cx. quinquefasciatus was more predominant (90%) over other species present. The average minimum and maximum atmospheric temperature recorded during the night catches were 27 and 29.5 degrees C while the average relative humidity range was 78-81.6%. The behavioural biting preference results obtained showed that the density of Cx. quinquefasciatus mosquitoes preferring the foot region (298) was significantly higher (p > 0.05) when compared with other different parts of the human host such as the ankle, calf and the thigh. INTERPRETATION & CONCLUSION: The study indicates that the foot region of the human host has a stronger influence in orientating mosquitoes towards the human host. Hence, the exploitation of the characteristic human odour will add to the existing vector control strategies.

Isolated perineal burn contractures presenting with chronic intestinal obstruction: a case report.

Isolated perineal burns are rare and so are perineal contractures. Perineal contractures may however lead to intestinal obstruction, which is a more life-threatening complication. A six-yr-old boy presented with chronic intestinal obstruction following isolated perineal contracture due to a deliberate perineal burn injury to treat a febrile convulsion. The obstruction was successfully relieved using local flaps to release the perineal contracture. There is a need for meticulous care in perineal burns to avoid perineal contractures, which may result in chronic intestinal obstruction.