# Trends in surgical indications and causative diagnoses in enucleation from 2007 to 2022

## TL;DR

This study examines why eye removal surgeries were performed at a major hospital from 2007 to 2022, finding a decline in procedures and shifts in reasons like pain or cancer.

## Contribution

The study provides updated trends in enucleation indications and causative diagnoses over a 15-year period in a tertiary eye center.

## Key findings

- The most common reasons for enucleation were painful blind eye and malignancy, with a decline in these indications over time.
- Choroidal melanoma was the leading causative diagnosis for enucleation.
- Only one enucleation was due to acute trauma, indicating rare emergency cases.

## Abstract

To evaluate surgical indications and causative underlying diseases in patients undergoing enucleation in a tertiary eye unit. Retrospective analysis of all enucleations performed at the University Eye Hospital of LMU Munich from January 2007 to December 2022. 491 eyes of 491 patients were enucleated in this period; 237 right and 254 left eyes. 59.3% (291) of patients were male, while 40.7% (200) were female. The median patient age at enucleation was 59 years (range 2–99, IQR 43–72). The four most common surgical indications were painful blind eye (318, 64.8%), malignancy (139, 28.3%), disfiguring blind eye (14, 2.9%) and treatment-refractory perforated corneal ulcer (13, 2.6%). There was only one indication for enucleation due to acute trauma (1, 0.2%). Information on causative diagnosis was available from 2013 to 2022 (257). The most common causative diagnoses leading to enucleation were choroidal melanoma (107, 41.6%), status post (s/p) trauma (65, 25.3%), and s/p retinal detachment (17, 6.6%). The annual enucleation count showed a decline from 2007 to 2022. Regarding indications for enucleation there is a negative trend for “painful blind eye” and “malignant tumor”. Our study demonstrates a decrease in the annual number of enucleations between 2007 and 2022. While the causative diagnoses remained unchanged over the last ten years, there was a negative trend in surgical indications due to malignant tumors and painful blind eyes. Only one enucleation was performed due to acute trauma.