Common Causes of Eye Removal Surgery in Turkish Patients: A Review of 226 Cases

Purpose: To evaluate the etiological factors that cause end-stage eye disease or phthisis bulbi requiring enucleation or evisceration and our surgical results. Material and Methods: Medical records of 226 patients, who underwent eye removal surgery, were analyzed retrospectively. Demographic information, clinical history, surgical procedure and histopathological data were all collected. Evisceration surgery was performed under general anesthesia in all patients except tumor cases and one patient with rhino-orbital mucormycosis. The patients were followed for an average of 16.46 ± 10.78 months and checked for the possible complications, cosmetic and functional results. Results: A 144 men, and 82 women, with a mean age of 41.78 ± 22.6 years, were underwent nucleation (n=15) or evisceration (n=211) due to traumatic (n=169) and non-traumatic (n=57) causes. In the traumatic group, 79.8% of 169 patients were injured by penetrating and 14.2% by blunt trauma. A 3.6% of the patients were injured in a traffic accident, and 2.4% of them were injured by explosives. In the non-traumatic group, 40% of 25 patients had post-traumatic endophalmitis, 32% had endophthalmitis due to corneal ulceration and melting, 24% had endophthalmitis after cataract surgery. One patient had panophthalmitis due to rhino-orbital mucormycosis. Another cause in the non-traumatic group was glaucoma, of which 92.3% had neovascular glaucoma and 8.7% had congenital glaucoma. Of the patients who were enucleated for tumor, 35.7% had retinoblastoma, 14.3% had medulloepithelioma, 42.9% had uveal melanoma and 7.1% had metastastatic tumor from paranasal sinuses. The most common complaint in the follow-up period was discharge, seen in all prosthesis wearing patients. 13.3% of the patients had itching due to ocular prosthesis. 4.4% of the patients were complaining about deep superior sulcus. 4.4% had pyogenic granuloma and 17.8% had implant exposure. Conclusion: Etiological factors should be carefully evaluated and precautions should take in order to reduce devastating effect of the physical loss of the eye.