Exenteration of the orbit in selected cases of severe orbital contracture.

Severe orbital contracture is treated with graft-covered conformers fixed to the orbit with wires, pins or a headcap. In spite of these vigorous techniques, failures occur. Exenteration was used in four cases of severe orbital contracture with deformity and restricted function of the eyelids. The patient was fitted in six to eight weeks with a prosthesis made from methyl methacrylate and silicone. The margins of the prosthesis were inconspicuous in contrast to older prostheses made entirely of methyl methacrylate. The flexible silicone was well tolerated by the skin of the orbital margins. Patient acceptance and cosmetic appearance has been excellent.