Orbital exenteration: A 15-year study of 38 cases

Arie Y. Nemet*, Peter Martin, Ross Benger, Georgina Kourt, Vidushi Sharma, Raf Ghabrial, Jenny Danks

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

42 Citations (Scopus)

Abstract

PURPOSE: To determine the clinical indications and outcomes after orbital exenteration when histologic margins were reported as "clear," examining factors affecting local and systemic recurrences and mortality. METHODS: Retrospective case review of exenterations performed in Sydney Eye Hospital in Sydney, Australia, between 1990 and 2004. Reviewed data indications for exenteration, histopathologic diagnosis, and recurrences on follow-up. RESULTS: Secondary intraorbital spread of malignant adnexal tumors was the most common indication for exenteration (34 of 38). Among these, the site of the primary neoplasm was the eyelid in 19 cases and the ocular surface in 12 cases. Exenteration was total in 26 cases, subtotal in 8 cases, and extended in 4 cases. In 11 cases, a dermis-fat graft was used for socket reconstruction; 24 cases were allowed to granulate spontaneously. The average healing time was 5 months (range, 4-6 months) for spontaneous granulation, and 6 weeks (range, 4-8 weeks) for dermis-fat grafts. Perineural spread was demonstrated histopathologically in 7 specimens. During follow-up (median, 48 months), there were 9 recurrences (23.7%): 3 local and 6 systemic. Seven patients (18.4%) died of the disease during the follow-up period. CONCLUSIONS: Dermis-fat grafts for reconstruction of the exenterated socket seem to optimize the aesthetic results. The first year is the most important period for follow-up of local recurrences, but systemic examination is needed for the longer follow-up. This may have implications in terms of reconstruction and adjunctive treatment following exenteration surgery.

Original languageEnglish
Pages (from-to)468-472
Number of pages5
JournalOphthalmic plastic and reconstructive surgery
Volume23
Issue number6
DOIs
Publication statusPublished - Nov 2007

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