Changing indications for enucleations in Hadassah University Hospital, 1960-1989.

The frequencies of various indications for enucleations have changed during the past decades. Knowledge of these trends may aid us in assessing the efficacy of early diagnostic techniques and improved modes of treatment. This study was designed to evaluate the indications for enucleations and their changes during a period of thirty years in a major Israeli medical center. We present a retrospective review of 463 enucleations performed between 1960 and 1989 at the Hadassah University Hospital, Jerusalem, Israel, and analyze the changes in the indications for enucleations. In our study, fewer enucleations were performed in the last two decades: 105 in the 1970's and 111 in the 1980's, as opposed to 247 in the 1960's. The incidence of enucleations due to glaucoma and to traumatic complications decreased significantly, from 22.3% in the 1960's to 7.7% glaucoma-related enucleations in the 1970's and 1980's, and 7.2% trauma-associated enucleations in the 1980's as opposed to 11.3% in the 1960's, reflecting improved medical management of these conditions. No significant change was noted in the frequency of enucleations due to inflammation, congenital disease or retinal detachment, nor in the number of malignant melanoma-related enucleations. The number of enucleations due to retinoblastoma rose in our study between 1960 and 1989.