Purchase this article with an account.
S. Mukerjee, M. Evans, L. LaBree, N.A. Rao; Changing Indications for Enucleation: A Retrospective Analysis Over a Fifty–Year Period from 1954 to 2004 . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3965.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To identify the current primary causes of enucleation and to ascertain if and how the pathological processes resulting in enucleation have evolved over five decades.
A retrospective review of the clinical and pathologic diagnoses of 2490 enucleated globes submitted to the Doheny Eye Institute Pathology Laboratory during a 50–year period between 1954 and 2004. The globes were classified based on histopathologic diagnosis and grouped into: trauma, tumor, end–stage glaucoma, long–standing retinal detachment, diabetes, infection, inflammation and uveitis, phthisis bulbi and atrophia bulbi, congenital disease, and other. Descriptive statistics were calculated to obtain a comparison of percentages of the above categories between each decade.
In 1954, the major causes of enucleation were trauma (29%), glaucoma (28%), tumor (15%) and inflammation (4%) By contrast in 2004, tumor (44%) was the primary cause of enucleation, followed by inflammation (14%), trauma (13%) and glaucoma (11%).The categories that showed at least one statistically significant change in percentage from one decade to the other were: diabetes, trauma, tumor, inflammation, long–standing retinal detachment, and glaucoma. Diabetic globes represented 7.43 % of enucleated globes in 1984, but decreased to 3.76% in 1994 and 1.97% in 2004 (P=0.05). Trauma decreased from 39.22% in 1974 to 29.05% in 1984 (P=0.04), while tumors increased from 18.92% in 1984 to 35.34% in 1994 (P=0.003). Inflammation increased from 0.98% in 1974 to 4.73% in 1984 (P=0.02). Long–standing retinal detachment represented 7.72% of enucleations in 1964, and decreased to 3.27 % in 1974 (P=0.03). Glaucoma decreased from 28.03% in 1954 to 10.53% in 2004% (P=0.0001).
There has been a significant overall decrease in the number of enucleated globes over the past five decades. There has also been a significant decrease in the number of enucleated specimens submitted with a diagnosis of glaucoma, retinal detachment, or diabetes–related ocular complications in recent years. This change reflects the introduction of glaucoma implant in 1973 and vitrectomy machine in 1972. Improved surgical management could also have played a role in the changing indications for enucleation.
This PDF is available to Subscribers Only