Gábor Tóth¹, Nóra Szentmáry1,2, Béla Csákány¹, Jeannette Tóth3, Zoltán Zsolt Nagy¹, Olga Lukáts¹
1 Semmelweis University, Department of Ophthalmology
2 Department of Ophthalmology, Saarland University Medical Center
3 Semmelweis Egyetem, 2. Department of Pathology
Introduction: Enucleation is the removal of the entire globe and a section of the optic nerve. It is sometimes an unavoidable end-stage solution for several ophthalmic diseases.
Aims: To analyse current clinicopathological enucleation indications in a large third-referral centre in a developed country (Hungary) over a period of 12 years.
Methods: Retrospective review was performed on 547 enucleated eyes of 543 patients (48.6% males, age 52.7 ± 24.5 years) that were operated on between 2006 and 2017 at the Department of Ophthalmology of Semmelweis University, in Budapest, Hungary. For each subject, clinicopathological data, including patient demographics, indications for enucleation, B-scan ultrasound reports, operative details and histopathological analyses, were reviewed. Primary enucleation indications were classified into trauma, tumours, systemic diseases, surgical diseases, infections or inflammations, miscellaneous diseases and unclassifiable groups. Clinical immediate enucleation indications were classified as tumours, atrophia or phthisis bulbi, infection or inflammation, painful blind eye due to glaucoma, acute trauma, threatening or spontaneous perforation, cosmetic causes and expulsive bleeding.
Results: The most common primary enucleation indications were tumours (47.3%), trauma (16.8%), surgical diseases (15.7%), infection or inflammation (11.6%), systemic diseases (5.1%), miscellaneous diseases (2.0%) and unclassifiable diseases (1.5%). Clinical immediate enucleation indications were tumours (46.1%), atrophia or phthisis bulbi (18.5%), infection or inflammation (18.5%), painful blind eye due to glaucoma (11.2%), acute trauma (3.7%), threatening or spontaneous perforation (1.3%), cosmetic reasons (0.5%) and expulsive bleeding (0.4%).
Conclusion: Intraocular malignant tumours represent the most common clinicopathological indication for ocular enucleation in our study population. Orbital implant financing should be increased to ensure better postoperative aesthetic rehabilitation, following enucleation in Hungary.
Doctoral School: Clinical Medicine
Supervisor: Prof. Dr. Zoltán Zsolt Nagy
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