Pattern of orbital exenteration in a tertiary eye care centre in India

This study aimed to determine the clinical indications for orbital exenteration, profile of these patients and clinicopathological correlations, and to compare these results with previous published data.

A retrospective analysis was conducted of exenterations performed in adults at a tertiary eye care centre in India over a period of 10 years (January 1990 to December 2000). Patient records were reviewed to obtain demographic data, presenting symptoms and their duration, laterality, and clinical and histopathological diagnosis.

A total of 26 cases were identified. Patients ranged in age from 32 to 72 years (mean +/- SD 58.7 +/- 9.23 years). No sex predilection was observed. Classification of cases on histopathological criteria showed that exenterations were performed mostly for squamous cell carcinoma (10 cases), followed by sebaceous gland carcinoma (six cases) and basal cell carcinoma (two cases) of the eyelid. Conjunctival malignant melanoma contributed to 5 of 26 cases of exenteration. Adenoid cystic carcinoma of the lacrimal gland (one case), neurofibroma (one case) and orbital fungal infection (one case) were the other indications of exenteration. The clinicopathological correlation was 100% for squamous cell carcinoma, 100% for basal cell carcinoma, 80% for malignant melanoma and 75% for sebaceous gland carcinoma.

Exenteration is mainly performed as a life-saving treatment for advanced malignant tumours with epithelial tumours being the commonest. In comparison to previous published data, the indications of surgery in India differed, as squamous cell carcinoma and sebaceous gland carcinoma were the commonest indications for exenteration.