Eyelid and conjunctiva sparing exenteration followed by microvascular free flap reconstruction - report of two cases

Eyelid and conjunctiva sparing exenteration (ECSE) allows for the extirpation of pathologies that lie deep within the orbit without disrupting the anatomy of the eyelids. Despite the cosmetic benefits of maintaining the eyelids, few cases of ECSE have been reported, and reconstruction following the procedure has only been detailed in the form of primary closure or a temporalis muscle transfer. The authors present two patients with deep orbital pathologies that extended into the intracranial space. Each patient underwent an extended ECSE followed by reconstruction with a microvascular free flap. The combination of ECSE plus microvascular free flap reconstruction offers an alternative approach to previously published techniques and may improve esthetic outcomes when exenteration is required for deep orbital pathologies.