Eye banking: techniques for eye preservation in selected neoplasms encroaching on the globe
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Published on: May 30, 2025
V C Quatela1, N D Futran, J R Boynton
1Department of Otolaryngology, Head and Neck Surgery, University of Rochester Medical Center, NY.
Abstract:
Removal of the globe and associated structures has been advocated for tumors invading the periorbital bone and periosteum, orbital fat, or extraocular muscles. In some patients with cancerous tumors encroaching on the globe, however, it may be possible to remove the tumor and save the eye. Tenon's fascia is a firm fibrous sheath surrounding the entire globe except the cornea. If the neoplasm spreads along fascial planes rather than through them, and if this layer remains free of tumor involvement, preservation of the globe can be considered. Oculoplastic reconstructive techniques may limit exposure and diplopia, allowing the eye to be "banked" in vivo, and saved as a spare for the future. Six patients with malignant tumors encroaching on the globe have had definitive surgical extirpation with preservation of the eye. Three patients have had the globe uncovered successfully. Five of six patients remain disease-free, with followup from 6 months to 6 years. No globes have been removed. These techniques appear to be therapeutically sound, preserve function and appearance, and improve patient morale. The indications and limitations of this approach to certain cases of periorbital cancer are discussed.
Insights
Oculoplastic surgery can save the eye in select periorbital cancer cases by removing tumors while preserving the globe. This approach offers a viable alternative to globe removal, maintaining function and appearance.
Area of Science:
- Ophthalmology
- Surgical Oncology
- Reconstructive Surgery
Background:
- Tumors invading orbital structures often necessitate globe removal.
- Preserving the globe is desirable for function, appearance, and patient morale.
Observation:
- Tenon's fascia, a sheath around the globe, can facilitate tumor dissection without globe invasion.
- Oculoplastic reconstructive techniques enable in vivo "banking" of the eye.
Findings:
- Six patients with malignant tumors underwent successful globe preservation.
- Five of six patients remained disease-free with 6 months to 6 years follow-up.
- No globes were removed in this series.
Implications:
- Globe preservation is a therapeutically sound option for specific periorbital cancers.
- Oculoplastic techniques improve outcomes, function, and patient well-being.
- This approach expands treatment possibilities for orbital malignancies.
