Orbital Exenteration: A 23-Year Report

Purpose: Orbital exenteration is a psychologically and anatomically disfiguring Procedure which indicated in some patients with malignant or progressive diseases of orbital and periorbital area. In this study, we reviewed 176 patients that underwent orbital exenteration. Methods: This was a retrospective study of medical records from all patients who underwent orbital exenteration from march 1991 to mrach 2014 in Oculoplastic Department at an eye care center. Demographic data, diagnosis, site of primary involvement and technique of surgery were determined in patients. Results: 176 cases of orbital exenteration were included that had documented histopathology. The age ofpatients ranged from1 year to 91 years (mean age (±SD) =55.43±27 years). 97(55.11%) males and 79 (44.88%) females were included. fifteen different tumors were identified. The most common indication was patients with basal cell carcinoma 49 (28%) followed by 41 (23.5%) Squamous cell carcinomas, 35(20%) retinoblastoma and 13 (7%) adenoid cystic carcinomas. In total, adnexal malignancies were the most common tumors, secondarily involving the orbit. Eyelids 89(50.5%) and the globe 43(24%) were the most frequent site of involvement. Three types of exentration were performed, based on available data of 129 operation sheets, 46(35.7%) Subtotal, 62 total (48.1%) and 21(16.3%) cases of Extensive exenterations. In total 97 cases were evaluated pathologically for perineural involvement, of which perineural invasion was noted in 9 reports (7%). Conclusion: In conclusion frequency of exenteration in our center has increased in past three years and the majority of cases were eyelid BCC. Patient education considering periocular lesions can help in earlier diagnosis of malignant lesions and therefore reducing the number of exnteration