Orbital exenteration: results of an individualized approach.

PURPOSE

The authors report and evaluate their experience with an individualized approach to orbital exenteration.

METHODS

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).

RESULTS

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.

CONCLUSIONS

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.