Critical analysis of methods of reconstruction of exenterated orbits.

Reconstructive procedures were used on 14 patients who had undergone orbital exenteration and radiotherapy for malignant tumours. All patients were tumour free after a follow-up of between 5 and 18 years. Reconstruction was carried out in 3 stages. In the first operation the orbit was filled, in the second the orbital rims and eyelids were shaped, and in the third a cavity for a static eye prosthesis was created. Critical assessment of results showed that the first stage alone produced a marked improvement in appearance and occluded existing fistulae. The subsequent procedures improved aesthetic results further. Difficulties were encountered from retraction of the tissues and insufficient tissue mobility.