Indications and surgical techniques for orbital exenteration

Indications for the mutilating operation of exenteration are enumerated. They usually involve a malignant neoplasm of the orbital contents, primary, direct extension, or adnexal tissue that cannot be controlled by simple excision or irradiation. Surgically, subtotal exenteration with partial preservation of lids and even conjunctiva may be achieved occasionally. However, total exenteration may be lifesaving. Techniques and precautions are discussed. Advantages and disadvantages of skin grafting that influence the postoperative care are noted.