A Systematic Review Article on Orbital Exenteration: Indication, Complications and Reconstruction Methods

Area of Science:

• Ophthalmology
• Oncology
• Surgical Oncology

Background:

• Orbital exenteration is an extensive surgical procedure involving the removal of orbital contents.
• It is indicated for aggressive malignancies of the orbit and surrounding structures.
• The procedure carries significant morbidity and potential complications.

Purpose of the Study:

• To systematically review the indications for orbital exenteration.
• To identify common complications associated with the procedure.
• To summarize various reconstruction methods used after orbital exenteration.

Main Methods:

• A systematic review of electronic databases (PubMed, MeSH, NLM Catalog, Bookshelf) was performed.
• The search covered a 20-year period from 1999 to 2019.
• Twenty-nine articles were included in the final review.

Main Results:

• The most common primary sites for malignancy leading to orbital exenteration were the eyelid and canthus.
• Basal cell carcinoma and squamous cell carcinoma were the most frequent pathologies, alongside intraocular tumors like retinoblastoma and melanoma.
• Sino-orbital fistula was the most common complication reported across studies.

Conclusions:

• Orbital exenteration is a morbid procedure with a high complication rate.
• Despite its extent, it provides acceptable survival rates and a good quality of life in properly selected patients.
• It remains a crucial treatment for aggressive periorbital, sinus, and intraocular malignancies.