Postoperative Outcomes of Enucleation Without Closure of the Conjunctiva.

PURPOSE: To evaluate the long-term outcomes of enucleation without conjunctival closure in a large patient cohort.

METHODS

A retrospective chart review was conducted from January 2011 to January 2024, examining 144 eyes of 143 patients who underwent enucleation without conjunctival closure by a single oculoplastic surgeon. Data collected included patient demographics, indications for surgery, implant types, and complications.

RESULTS

This study included 144 eyes from 143 patients undergoing enucleation without conjunctival closure. Patients had a mean age of 46.47 years (SD: 19.76; range: 4-92 years), with a mean follow-up of 14.66 months (range: 2-142 months). Indications for enucleation included blind painful eyes for a variety of reasons (e.g., endophthalmitis, end-stage glaucoma, irreparable corneal graft failure, irreparable corneal melt, and intraocular tumors, etc.) which was the most common reason in our practice (72.92%). Porous polyethylene spheres (86.11%) and polymethyl methacrylate spheres (13.89%) were the primary implants used, with no observed implant complications. Three cases (2.08%) developed conjunctival cysts post-trauma.

CONCLUSIONS

Enucleation without conjunctival closure in an otherwise normal eye with no evidence of severe conjunctival shrinkage appears to be a safe and effective procedure with a low complication rate comparable to traditional techniques involving suture-based conjunctival approximation. Meticulous closure of Tenon's capsule may be sufficient to prevent implant-related complications. This approach could potentially reduce surgical time and simplify the enucleation procedure without compromising patient outcomes.