Eye removal surgeries at Mulago National Referral Hospital - patterns and quality of life of affected patients.

Abstract

Background: Eye removal surgeries are done when the eye becomes detrimental to health in cases such as trauma, tumors, infections, and more. Consequences like job loss and mental stress affect the quality of life of patients. Investigating the current patterns of eye removal surgeries and their impact on quality of life is crucial to ensuring appropriate rehabilitation services are provided.

Purpose: To describe the pattern of eye removal surgeries from 2018 to 2022 and assess the quality of life of affected patients at Mulago National Referral Hospital, Uganda.

Methodology: This was a hospital-based cross-sectional study design that included 257 case files of patients who underwent eye removal surgery from 2018 to 2022 at MNRH, Uganda, by consecutive sampling. The case file data was retrieved using a data collection tool. 88 patients were contacted thereafter, and their quality of life was measured using the interview-administered SF-36 and PSS-10 tools. Data was entered using Epidata version 4.6 and analyzed using STATA version 14.0.

Results: The study involved participants with a mean age of 30.2 years, with the under-20 age group most affected (37.4%). Evisceration (48.6%) was the primary surgery, followed by enucleation (35%) and exenteration (16.4%). The main indication was tumors (48.6%), particularly retinoblastoma and squamous cell carcinoma. Poor SF-36 scores in role limitations due to physical (51.1, SD=41.7) and emotional issues (47.7, SD=45.4) led to reduced quality of life (QOL). Patients with ocular prostheses had significantly better QOL (p<0.05) than those without. QOL declined with surgery type: evisceration, enucleation, and exenteration.

Conclusion: The causes of most indications that lead up to eye removal surgery are preventable through eye health promotion, sensitization, and the implementation of screening programs for ocular tumors. The poor QOL, especially of patients without ocular prostheses, may be improved through comprehensive post-surgical rehabilitation services that include scheduled counseling sessions and the provision of prostheses to improve patients' quality of life.