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. 2025 Aug 1;15(1):28120.
doi: 10.1038/s41598-025-13975-4.

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

Nicolas Pensel  1 , Siegfried Priglinger  1 , Christoph Hintschich  1 , Anna Schuh  2
Affiliations

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

Nicolas Pensel et al. Sci Rep. .

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.

Keywords: Enucleation; Evisceration; Painful blind eye; Trauma.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Ethics approval: The study was approved by the Institutional Review Board of the Ludwig-Maximilians-University Munich (reference number 23-0540). The tenets of the Declaration of Helsinki were followed throughout the study.

Figures

Fig. 1
Fig. 1
Distribution of causative diagnoses by surgical indication. The three main surgical indications categorized by causative diagnoses for enucleation in all patients who underwent enucleation during 2013–2022, displayed in pie charts.
Fig. 2
Fig. 2
Annual number of enucleations from 2007 to 2022. The x-axis represents the calendar year, the y-axis shows the total number of enucleations performed each year. The number of enucleations per year exhibited a consistent decrease from 2007 to 2022, with an overall percentage change of −33.3% (median annual change: −7.7%; IQR −22.2–23.6%, Student’s t =  −3.14, p < 0.001, sieve-bootstrap t-test).
Fig. 3
Fig. 3
Annual number of enucleations by major surgical indication from 2007 to 2022. The x-axis represents the calendar year, the y-axis shows the total number of enucleations performed per year for each surgical indication. Each point indicates the annual count for an indication; dashed lines connect the points to illustrate trends over time. Surgical indications with fewer than five cases overall were excluded.
Fig. 4
Fig. 4
Distribution of total enucleations grouped by patient age and sex. Age groups were defined in 10-year increments (e.g., 0–9, 10–19, 20–29, etc.). The x-axis shows the age groups, the y-axis shows the total number of enucleations performed over the 16-year period (2007–2022). Data are further stratified by sex (blue = male and red = female).
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