View 2019 Abstracts

The purpose of this study is to report the indications for eye removal, and histopathological findings in anophthalmic surgeries performed in three eye units across the North East over a 5 year period. Anophthalmic surgery is an increasingly rare procedure. However, understanding the indication and a sequence of events which precede and lead to anophthalmic surgery, is beneficial in preventing it.

A multi-centred, regional retrospective 5 year case study of all the anophthalmic surgery as carried at North East was carried out between 01.01.2012 and 31.12.2016. These Included 2 tertiary referral centres, Royal Victoria Infirmary at Newcastle, James Cook University Hospital at Middlesbrough along with Sunderland Eye Infirmary. The analysis included age, sex, type of surgery, indication, and underlying diagnosis. Histological diagnosis was also recorded.

63 eyes of 62 patients were identified for inclusion in the study. 33% of patients were females and 66% were males. Mean age was 57 years old, with the youngest patient being 12 and the oldest 90 years old. 1 patient unfortunately had bilateral evisceration secondary to underlying microphthalmia complicated by glaucoma. Painful blind eye (39/63) was the most common indication for anophthalmic surgery, followed by malignancy (7/63), perforation (8/63), infective causes including endophthalmitis (4/63), trauma (3/63) and poor cosmesis (1/63). Over 2 thirds of enucleations and eviscerations were performed on an elective basis (44/64). Trauma and infectious causes were more likely to undergo urgent surgery (anophthalmic surgery within a week of the decision to remove the eye). Only 2 cases were considered to have been performed on an emergency basis, and only 1 of these was operated on out of hours. Histologic assessment did not demonstrate any unexpected findings. ocular melanoma accounted for all cases of ocular malignancy in this series. There were no cases of sympathetic ophthalmia noted during the study period.

Evisceration was performed more commonly overall in our series. This may reflect changing practice patterns, including the centralisation of ocular oncology services. In our region, anophthalmic surgery remains a tool in the management of severely traumatised eyes, although rarely in the emergency setting.