A decade of surgical eye removals in Ontario: a clinical-pathological study

Abstract

A blind painful eye and neoplasms were the most commonly documented indications prior to removal of the eye. Common pathologies included glaucoma, neoplasms, infection/inflammation, and trauma. However, regardless of the primary cause, glaucoma-related pathologies were the most common pathologic findings. Refractory eye disease and pain continue to be important reasons for removal of eyes among patients in Ontario. More effective and targeted management strategies are needed to reduce the need for this radical eye surgery of last resort.

Changing indications for enucleation and selected unusual pathologies

“…A follow-up study covering 1992–2004 identified 56 enucleations, with the commonest indication being trauma followed by tumour 4 . A Canadian study of 713 eyes received over a 10-year period (60% of which were enucleations) found the commonest indication to be blind painful eye (37%) with slightly fewer tumours (35%) 5 …”

From post-war reconstruction to the 21st century – Ophthalmic pathology in Freiburg 1945- 2015: Review of 39,256 surgical specimens from various topographical regions collected over 71 years at a large German tertiary eye care centre

“…[28] found a high percentage of malignant tumours of 27% in their Copenhagen study population, compared to ndings by de Gottrau et al [29] in Erlangen (19.6%), Saeed et al [30] in Leeds (19%) and our own data from the Freiburg region (18%), during comparable time ranges. Even more pronounced was the percentage of malignant tumours in Atlanta in 1995 (30.8%) [17] and in Toronto 2004-2013 (36%) [32]. We assume that referral patterns may have played a signi cant role, as ocular tumour cases were referred to specialized tertiary care centres for intraocular tumours, such as in Copenhagen [28], Atlanta [17] and Toronto [32].…”

“…Even more pronounced was the percentage of malignant tumours in Atlanta in 1995 (30.8%) [17] and in Toronto 2004-2013 (36%) [32]. We assume that referral patterns may have played a signi cant role, as ocular tumour cases were referred to specialized tertiary care centres for intraocular tumours, such as in Copenhagen [28], Atlanta [17] and Toronto [32].…”

“…Geirsdottir et al [31] analysed medical records of 56 patients at The National University Hospital of Iceland, Reykjavik, Iceland, who underwent enucleation between 1992 and 2004. Chan et al [32] assessed patient demographics, clinical indications and pathologic causes of 713 surgically removed eyes received from the University of Toronto Ophthalmic Pathology Laboratory, enucleated between 2004 and 2013 at 28 health centres in Ontario, Canada.…”

A triple-layered closing technique using the recti muscles to augment implant coverage in eye enucleation after maxillofacial radiotherapy: A case report

“…For patients presenting phthisis bulbi with history of ocular neoplasia, eye enucleation (EE) appears to be one of the possible options to insure better facial appearance and pain relief [3]. EE involves the complete removal of the eye's contents and the scleral shell preserving the extraocular muscles.…”