Goldberg Robert A, Kim Jonathan W, Shorr Norman
Division of Orbital and Ophthalmic Plastic Surgery, Jules Stein Eye Institute, University of California, Los Angeles, School of Medicine, Los Angeles, California 90095, USA.
Ophthalmic Plast Reconstr Surg. 2003 May;19(3):229-36. doi: 10.1097/01.iop.0000066699.53489.88.
The authors report and evaluate their experience with an individualized approach to orbital exenteration.
Retrospective chart review was performed on a consecutive series of 25 orbital exenteration patients at a tertiary care center. The cases were classified into two groups for the retrospective analysis: Total exenteration procedures involved the removal of the entire orbital contents including the periorbita (13 cases), and subtotal procedures preserved at least a quadrant of the orbit or the orbital tissues posterior to the globe (12 cases).
The total exenteration group had a lower rate of clear surgical margins and a higher rate of systemic metastasis, whereas patients in the subtotal exenteration group had fewer surgical complications and better functional and aesthetic results.
The surgical planning for orbital exenteration should take into account the location, extent, and biological behavior of the orbital disease process and the reconstructive and prosthetic options for the exenterated socket. When an individualized approach to orbital exenteration is used, subtotal procedures can offer improved functional and aesthetic results while still maximizing the chances for a surgical cure.
作者报告并评估他们采用个体化方法进行眼眶内容剜除术的经验。
对一家三级医疗中心连续收治的25例眼眶内容剜除术患者进行回顾性病历审查。为进行回顾性分析，将病例分为两组：全眼眶内容剜除术包括切除整个眼眶内容物，包括眶骨膜（13例），而次全眼眶内容剜除术保留至少一个象限的眼眶或眼球后方的眼眶组织（12例）。
全眼眶内容剜除术组手术切缘阴性率较低，全身转移率较高，而次全眼眶内容剜除术组患者手术并发症较少，功能和美学效果较好。
眼眶内容剜除术的手术规划应考虑眼眶疾病进程的位置、范围和生物学行为以及剜除术后眼窝的重建和修复选择。当采用个体化的眼眶内容剜除术方法时，次全眼眶内容剜除术可提供更好的功能和美学效果，同时仍能最大限度地提高手术治愈的机会。
