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      Two 11-Years Periods Statistics and Trends of Enucleation and Evisceration

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          Abstract

          Purpose:

          The indications for evisceration and enucleation are still evolving and controversial. The study aims to describe trends of enucleation versus evisceration in one center.

          Methods:

          In period 1998–2019 were 353 patients were included in the study. Statistical results and Chi-square test for pair-wise comparisons for the statistical significance in comparing two subgroups (years periods 1998–2008 and 2009–2019) per category have been evaluated.

          Results:

          The enucleation was performed in 306 patients, and the evisceration was performed in 47 patients. In 221 patients with the tumor exclusively enucleation was indicated. For the operation technique, the authors got a chi-square value of 0.027, and the associated P value is at 0.8695, then the number of evisceration and enucleation in subgroups have not confirmed independency. For the tumor presence, the authors got a chi-square value of 5.4, and the associated P value is at 0.02, then the number of validated/nonvalidated tumor presence in subgroups confirmed independency.

          Conclusions:

          The performed enucleations had 98% cases uveal melanoma, 1% of cases of another type of malignancy (lymphoma non-Hodgkin type), and 1% cases with benign tumor. Enucleation is also today most frequently due to malignant intraocular tumors, whereas evisceration if most frequently for the phthisis eye after a trauma or a previous intraocular surgery. In our study in 22 years interval also in the second period, there was an increased trend of enucleation due to intraocular malignancy. It can have many reasons, especially, that patients are sent to oncology centers late in the advanced stage of tumor.

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          Most cited references39

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          Uveal melanoma

          Uveal melanoma (UM) is the most common primary intraocular malignancy in adults. UMs are usually initiated by a mutation in GNAQ or GNA11, unlike cutaneous melanomas, which usually harbour a BRAF or NRAS mutation. The annual incidence in Europe and the USA is ~6 per million population per year. Risk factors include fair skin, light-coloured eyes, congenital ocular melanocytosis, ocular melanocytoma and the BAP1-tumour predisposition syndrome. Ocular treatment aims at preserving the eye and useful vision and, if possible, preventing metastases. Enucleation has largely been superseded by various forms of radiotherapy, phototherapy and local tumour resection, often administered in combination. Ocular outcomes are best with small tumours not extending close to the optic disc and/or fovea. Almost 50% of patients develop metastatic disease, which usually involves the liver, and is usually fatal within 1 year. Although UM metastases are less responsive than cutaneous melanoma to chemotherapy or immune checkpoint inhibitors, encouraging results have been reported with partial hepatectomy for solitary metastases, with percutaneous hepatic perfusion with melphalan or with tebentafusp. Better insight into tumour immunology and metabolism may lead to new treatments.
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            Ocular treatment of choroidal melanoma in relation to the prevention of metastatic death – A personal view

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              Management of posterior uveal melanoma: past, present, and future: the 2014 Charles L. Schepens lecture.

              To review the management of ciliary body and choroidal melanoma (posterior uveal melanoma [PUM]) over the last century with an emphasis on changing concepts.
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                Author and article information

                Journal
                J Craniofac Surg
                J Craniofac Surg
                JCRSU
                The Journal of Craniofacial Surgery
                Lippincott Williams & Wilkins (Hagerstown, MD )
                1049-2275
                1536-3732
                Nov-Dec 2021
                19 May 2021
                : 32
                : 8
                : 2701-2705
                Affiliations
                []Department of Ophthalmology, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic
                []Department of Information Systems, Faculty of Management, Comenius University
                []Department of Stereotactic Radiosurgery, St. Elisabeth Cancer Institute and St. Elisabeth University College of Health and Social Work
                [§ ]Institute of Automation, Measurement and Applied Informatics, Faculty of Mechanical Engineering, Slovak University of Technology, Bratislava, Slovak Republic.
                Author notes
                Address correspondence and reprint requests to Alena Furdova, PhD, MD, Department of Ophthalmology, Faculty of Medicine, Comenius University, Bratislava, (Klinika oftalmológie LFUK a UNB), Hospital Ružinov, Ružinovská 6, 826 06 Bratislava, Slovak Republic; E-mail: alikafurdova@ 123456gmail.com
                Article
                SCS-21-0476 00032
                10.1097/SCS.0000000000007727
                8549453
                34015800
                3f3f2671-9277-4e2e-86e3-64cff68a67e9
                Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of Mutaz B. Habal, MD.

                This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0

                History
                : 15 February 2021
                : 02 March 2021
                Categories
                Clinical Studies
                Custom metadata
                TRUE

                anophthalmic socket,neovascular glaucoma,orbital surgery,tumors/neoplasms,uveal tumors

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