Abstract
Orbital exenteration consists of removal of all orbital contents and is typically performed as a life-saving procedure in high-grade malignancies or severe infection or inflammation. A thorough but prompt preoperative evaluation is required to formulate an appropriate surgical plan for each patient, which sometimes requires a multidisciplinary team. Depending on the indication, total exenteration or subtotal exenteration with eyelid-sparing approach can be taken, followed by socket reconstruction via a skin graft, myocutaneous advancement flap, free flap, dermal substitute, or a combination thereof. Custom-made oculofacial prosthesis can be fitted thereafter for cosmesis and comfort.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Bartley GB, Garrity JA, Waller RR, et al. Orbital exenteration at the Mayo Clinic: 1967–1986. Ophthalmology. 1989;96:468–74.
Shields JA, Shields CL, Demirci H, Honavar SG, Singh AD. Experience with eyelid-sparing orbital exenteration: the 2000 Tullos O. Coston Lecture. Ophthal Plast Reconstr Surg. 2001;17(5):355–61.
Levin PS, Dutton JJ. A 20-year series of orbital exenteration. Am J Ophthalmol. 1991;112:496–501.
Kiratli H, Koç İ. Orbital exenteration: institutional review of evolving trends in indications and rehabilitation techniques. Orbit. 2018;37(3):179–86.
Nagendran ST, Lee NG, Fay A, Lefebvre DR, Sutula FC, Freitag SK. Orbital exenteration: the 10-year Massachusetts Eye and Ear Infirmary experience. Orbit. 2016;35(4):199–206.
Ben Simon GJ, Schwarcz RM, Douglas R, Fiaschetti D, McCann JD, Goldberg RA. Orbital exenteration: one size does not fit all. Am J Ophthalmol. 2005;139(1):11–7.
Tse D. Color atlas of oculoplastic surgery. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2012.
Zhang Z, Ho S, Yin V, Varas G, Rajak S, Dolman PJ, et al. Multicentred international review of orbital exenteration and reconstruction in oculoplastic and orbit practice. Br J Ophthalmol. 2018;102(5):654–8.
Elner VM, Demirci H, Nerad JA, Hassan AS. Periocular necrotizing fasciitis with visual loss pathogenesis and treatment. Ophthalmology. 2006;113(12):2338–45.
Rose GE, Wright JE. Exenteration for benign orbital disease. Br J Ophthalmol. 1994;78(1):14–8.
Thach AB, Johnson AJ, Carroll RB, Huchun A, Ainbinder DJ, Stutzman RD, Blaydon SM, Demartelaere SL, Mader TH, Slade CS, George RK, Ritchey JP, Barnes SD, Fannin LA. Severe eye injuries in the war in Iraq, 2003-2005. Ophthalmology. 2008;115(2):377–82.
Mauriello JA Jr, Han KH, Wolfe R. Use of autogenous split-thickness dermal graft for reconstruction of the lining of the exenterated orbit. Am J Ophthalmol. 1985;100(3):465–7.
Rafailov L, Turbin RE, Langer PD. Use of bilayer matrix wound dressing in the exenterated socket. Orbit. 2017;36(6):397–400.
Ozgonul C, Diniz Grisolia AB, Demirci H. The use of Integra® dermal regeneration template for the orbital exenteration socket: a novel technique. Ophthal Plast Reconstr Surg. 2018;34(1):64–7.
Nerad JA, Carter KD, LaVelle WE, Fyler A, Brånemark PI. The osseointegration technique for the rehabilitation of the exenterated orbit. Arch Ophthalmol. 1991;109(7):1032–8.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Choi, C.J. (2020). Exenteration and Multidisciplinary Approaches. In: Johnson, T. (eds) Anophthalmia . Springer, Cham. https://doi.org/10.1007/978-3-030-29753-4_8
Download citation
DOI: https://doi.org/10.1007/978-3-030-29753-4_8
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-29752-7
Online ISBN: 978-3-030-29753-4
eBook Packages: MedicineMedicine (R0)