Twenty year review of histopathological findings in enucleated/eviscerated eyes

Abstract

Background/Aims: To evaluate the need for routine histopathological analysis of enucleated/eviscerated eyes and changes in indications for eye removal. Methods: Retrospective review of all enucleation/evisceration histopathology reports over 20 years. Clinical history was correlated with pathological findings. Two 10 year periods (1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003) were compared to detect changes in indications for eye removal. Results: In total, 285 histopathology results were traced from 1984 to 2003; 161 and 124 were evisceration and enucleation specimens, respectively. Glaucoma, malignant melanoma, trauma, and retinal detachment were the most frequent diagnoses 1984-1993. Ocular trauma was the most frequent diagnosis 1994-2003, followed by phthisis bulbi and endophthalmitis. Three cases were diagnosed as metastatic carcinoma; all were suspected preoperatively. A fourth case was a diagnostic surprise: adenocarcinoma found in an eye removed for pain and phthisis. Comparison of two 10 year periods showed a decrease in the number of enucleations/eviscerations, perhaps reflecting a decrease in the number of specimens sent. A preference for eviscerations was evident over the 20 years. Conclusion: The number of eyes removed and histologically analysed decreased in the period 1994 to 2003, perhaps because of better treatment options, allowing globe preservation. There was a significant shift in the diagnosis in the two time periods, and a preference for evisceration in both. Only one diagnostic surprise was discovered (0.35%). This study does not support the need to send all globes/contents for histopathological examination. However, because of the one unexpected finding, it is recommended where the examination is incomplete or the history of visual loss is unclear.

Review of 1375 enucleations in the TongRen Eye Centre, Beijing

“…In the United Kingdom, for the period from 1994 to 2003, Saeed et al reported a sequence of causes for ocular enucleations starting with ocular trauma, followed by phthisis bulbi and endophthalmitis. 8 Although in the present study, the sequence of clinical indications for ocular enucleation was similar to the findings of de Gottrau and Naumann from Germany, 1,2 with trauma (37.4%), malignant intraocular tumours (19.6%), systemic diseases (17.1%), surgical complications (14.1%), and intraocular infection and inflammation (7%) in the list, the proportion of ocular trauma (62.5%) and malignant intraocular tumours (28.5%) were higher in the present study. In the latter study, the reasons for ocular enucleations owing to ocular traumata might have slightly shifted from surgical difficulties in salvaging the eye and pain alleviation to eventually cosmetic reasons to remove the deformed eye.…”

Perfil dos pacientes submetidos à reconstrução primária da cavidade orbitária com implante de Mules após enucleação e evisceração

“…As principais etiologias que desencadearam a retirada do globo ocular foram trauma ocular, glaucoma, melanoma de coróide e phthisis bulbi. Não obstante, este resultado foi semelhante ao encontrado em outros estudos (10,12,14,15) ; embora a endoftalmite, em alguns destes estudos, tenha se destacado dentre as principais complicações, fato não sucedido neste trabalho.…”

“…A alta frequência do trauma ocular é vista em vários estudos (5,8,13,14,16) , segundo um estudo em Bogotá (Colômbia), onde dos 370 pacientes submetidos à cirurgia de enucleação ou evisceração, 49,19% revelaram como etiologia o traumatismo ocular (17) . Há também um trabalho em que foram analisados 890 casos de enucleação durante um período de 22 anos, onde 39,7% dos casos corresponderam ao trauma ocular (18) .…”

Perfil biopsicossocial de portadores de anoftalmia no sul de Minas Gerais - Brasil

“…Entretanto, para além da função de percepção, os olhos representam um importante fator psicodinâmico, pela sua grande influência no relacionamento social (6) . Sendo assim, em decorrência dos avanços tecnológicos e científicos no campo da oftalmologia, a remoção do globo ocular tem-se tornado cada vez menos freqüente, sendo indicado apenas quando todas as possibilidades de manutenção do olho forem esgotadas, visto ser este um procedimento dos mais traumatizantes (13) .…”

“…Tais fatos levam à necessidade de apoio e encorajamento e, sendo assim, um tratamento personalizado pode ser oportuno (5) . Dessa forma, é importante a atuação multiprofissional e interdisciplinar, visando oferecer a melhor reabilitação possível ao indivíduo afetado, de forma a minimizar o impacto que esta condição propicia (6) . Com relação à etiologia da perda do globo ocular verificase variação na literatura científica.…”