Analysis of 24,444 surgical specimens accessioned over 55 years in an ophthalmic pathology laboratory

To summarize the pathologic diagnoses of a large number of surgically-obtained specimens over an extended time period in a single ophthalmic pathology laboratory.

We analyzed the records of 24,444 surgically obtained specimens accessioned in the L.F. Montgomery Ophthalmic Pathology Laboratory, Emory University, Atlanta, GA between May 1941 and December 1995. Age, sex, topography, clinical procedure, and histologic diagnosis were entered into a database using the modified SNOMED coding system. The diagnosis of the surgically enucleated eyes were analyzed with respect to years of enucleation.

The most common topographic area associated with a histologic diagnosis was the cornea (39.3%), followed by lens (16.0%), vitreous (12.0%), uvea (9.8%), eyelids (8.0%), conjunctiva (7.7%), retina (7.7%), and orbit (2.1%). The relative proportion of vitreous specimens has continuously increased and became the most common surgical specimen in 1995. The most common underlying disease of surgically enucleated eyes is trauma (40.9%), followed by ocular neoplasia (24.2%), 'surgical' diseases of the cornea, lens and retina including glaucoma (17.3%), vascular diseases (6.7%), and inflammatory conditions (6.7%). The relative frequency of trauma and ocular inflammation as a cause of enucleation decreased significantly (p < 0.05) over the time of the study period while the relative proportion of ocular neoplastic processes increased (p < 0.0001).

The availability of new surgical techniques has caused a change in the relative frequencies of different ocular specimens submitted for histologic examination.