An Analysis of Destructive Surgeries of the Eye at Jimma University Medical Center, Jimma, Oromia, Ethiopia.

Abstract

Background: - Destructive eye surgeries (DES) is a management option offered patients when further retention of the globe is likely to affect ocular or general health. DES includes exenteration, enucleation, and evisceration. The decision to perform DES is usually distressing to all concerned; the patients, their relatives, and the Ophthalmologist; and is taken as a last resort. Objective: - The aim of this study is to assess the patient demographics, frequency, and indications for destructive eye surgeries at Ophthalmology department of Jimma University Medical Center with the aim of identifying the preventable causes for which appropriate preventive measures could be recommended. Method: - A retrospective descriptive study of all patients who underwent evisceration, enucleation or exenteration at Ophthalmology Department, JUMC from May 2017 to August 2022 G.C was conducted. Data was retrieved from minor and major Operation room records and patient card were reviewed. Information collected includes age, sex, occupation, eye affected, indications for surgery and type of destructive surgery. Data was entered into Epidata and analyzed by SPSS 26. The groups were compared using the Chi square test for categorical variables. One way ANOVA also used. Result: - A total of 184 eyes of 183 patients, who had undergone destructive eye surgery, were reviewed. The mean age of the patient was 40.04 ± 23.49 years, median 40 years, with a range of 2 months to 85 years. Male to Female ratio was 1.4:1. Evisceration was the most common surgery performed in 153 cases (83.15%), followed by enucleation in 16 cases (8.7%) and exenteration in 15 cases (8.15%). The most common indication in our study was ocular infection (33.15%), staphyloma (21.19%), neoplasia (16.30%) and open globe injury (10.33%). SCC was the most common indication for exenteration while RB for enucleation. Eye implant and prosthesis placement was performed for 16.57% and 5.97% eyes respectively. Conclusion: - Ocular infection, staphyloma and tumor were the most common indications for destructive eye surgery in our center. Most of the ocular conditions leading to DES were preventable. Hence proper care, public awareness, and protective measures for maintaining ocular health can reduce the burden of such destructive surgeries.