Enucleations performed by the ophthalmology service have lower complication rates when compared to enucleations performed by the emergency service

Objective: To compare patient characteristics, surgical techniques, and outcomes of enucleations performed by emergency service (ES) versus ophthalmology service (OPH) clinicians at a veterinary teaching hospital. Methods: Medical records over a 5-year period were reviewed for signalment, indication, surgeon affiliation, surgical technique, perioperative management, and complications. Results: Records from 576 dogs and cats (468 OPH cases and 118 ES cases) were identified for review. Emergency service enucleations were more often performed after hours (16.1% vs 1.3%) and on weekends (37.3% vs 3.3%) and were primarily performed by rotating interns and ES residents, whereas OPH cases were typically performed on weekdays by ophthalmology residents or specialty interns or faculty. Common ES indications were proptosis (24.6%) and perforated corneal ulcers (39.0%), whereas OPH cases most often involved glaucoma (21.4%), uveitis (18.8%), or neoplasia (11.6%). Cases from ES were significantly less likely to receive preoperative bloodwork, intraoperative antibiotics, or local anesthetic blocks. Intraoperative hemorrhage occurred in 14.4% of ES versus 0.4% of OPH cases. Postoperative complications, including dehiscence (6.8%), infection (6.8%), and draining tracts (2.5%), were also significantly more frequent in ES cases (16.9% vs 0.7%). Financial limitations were commonly cited as the reason for ES enucleations. Conclusions: Patient and procedure characteristics differed between ES and OPH cases. Dogs and cats enucleated by ES experienced significantly more intraoperative and postoperative complications. Clinical Relevance: Findings support the need to train ES clinicians to perform enucleations. Specific training focusing on circumstances surrounding ES cases can potentially mitigate complications and improve outcomes.