Indications for Destructive Eye Surgeries among Children in a Tertiary Eye Care Center in North-Central Nigeria: A Ten Year Review

Abstract

This study aimed to assess the indications for destructive eye surgeries (DES) among children and ascertain the proportion avoidable. The Eye theatre register was retrospectively reviewed. Data on children who had DES from 1st January 2008-31st December 2017 was retrieved. These included biodata; clinical presentation, diagnosis, indication and type of surgery, and outcome of management. The total number of paediatric ophthalmic surgeries within the study period was computed. The data were entered into Epi Info statistical software, version 3.4 for analysis. Descriptive and analytical statistics were applied, p-values < 0.05 were considered statistically significant. A total of 634 ophthalmic surgeries were performed on children within the study period, 50(7.9%) eyes of 49 children had destructive eye surgeries. Thirty-three (67.3%) were males and 16(32.7%) were females; M:F ratio was 2.1:1. The mean age was 6.7±5.0 years with a range of 1.7-11.7years (Mean±SD). Most, 27(55.1%) of the participants had evisceration, 15(30.6%) had enucleation while 7(14.3%) had exenteration. More males, 24(72.7%) had evisceration while more females 10(62.5%) had enucleation (Fisher’s exact test=13.8, p=0.001). The main indications for DES included tumour in 22(44%) eyes, trauma to eyes in 13(26%) and intractable infections in 8(16%) eyes. All the 15 eyes enucleated were confirmed cases of retinoblastoma. Seven (14.3%) persons had orbital exenteration of which 6(85.7%) were retinoblastoma. In all, 42(84%) destructive eye surgeries in this study were avoidable. There is a need for improved enforcement of the “Child’s Right Act” in our environment.