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

Emergency service enucleations carry significantly higher complication rates, underscoring the urgent need for targeted surgical training.

This retrospective study compared enucleation outcomes between emergency service (ES) and ophthalmology service (OPH) clinicians at a veterinary teaching hospital over a 5-year period, reviewing 576 cases (468 OPH, 118 ES) in dogs and cats. Significant differences existed in case demographics, timing, indications, and perioperative management. ES cases were more frequently performed after hours and on weekends by rotating interns and residents, often driven by financial constraints. Common ES indications included proptosis (24.6%) and perforated corneal ulcers (39.0%), while OPH cases involved glaucoma (21.4%), uveitis (18.8%), and neoplasia (11.6%). ES cases were significantly less likely to receive preoperative bloodwork, intraoperative antibiotics, or local anesthetic blocks. Intraoperative hemorrhage was markedly higher in ES cases (14.4% vs 0.4%), and postoperative complications—including dehiscence (6.8%), infection (6.8%), and draining tracts (2.5%)—occurred far more frequently in ES patients (16.9% vs 0.7%). These findings highlight substantial disparities in patient preparation, surgical technique, and perioperative care between service types. The authors conclude that targeted training programs for emergency clinicians focusing on proper surgical technique, perioperative analgesia, antibiotic prophylaxis, and complication management are essential to improving outcomes for patients requiring emergency enucleation, particularly given the time-sensitive and resource-limited circumstances that often surround these cases.

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