[Enucleations and eviscerations in a large medical center between the years 1981 and 2007]

The indications for enucleation and evisceration have decreased in the last decade, most probably because of improved treatment modalities. The aim of the study was to evaluate the use of these procedures in the last 26 years in our medical centre.

This study included all patients who underwent enucleation or evisceration at Rabin Medical Center from 1981 to 2007. We checked for age, gender, date and type of surgery, and indication for surgery.

A total of 206 (74%) eviscerations and 73 (26%) enucleations were performed. The relative rates of performance of the two procedures were similar in 1981-1990 and 1991-2000. Mean age of the patients treated from 1981 to 1990 was 57.03 years (SD=22.23), from 1991 to 2000, 68.55 years (SD=17.94) and 69.23 years (SD=20.23) during the period 2001-2007 (p=0.001, t-test). Indications for surgery were: trauma in 91 eyes (32.6%), blind painful eye (mainly due to end-stage glaucoma) in 77 eyes (27.6%), endophthalmitis in 76 eyes (27.2%), and tumor in 35 eyes (12.6%). In the first 2 decades, trauma was the most common reason for evisceration, whereas, in the last few years, endophthalmitis or severe intraocular infection became the main reason for the procedure. Tumor was the most common reason for enucleation throughout all decades.

The relative use of enucleation and evisceration and indications for these procedures has not changed over that last 2 decades. However, in recent years, severe intraocular infection became the most frequent indication for evisceration, while enucleation is less frequently performed then previously. There has been a significant shift to an older patient age group.