Orbital exenteration is the surgical excision of the eyeball as well as the surrounding tissues such as the eyelids (depending on the pervasiveness of the disease being treated, and the nerves, muscles, and fatty tissues in the eye area.
Orbital exenteration is an intricate eye surgery procedure. It is typically performed to eliminate a cancerous tumor which affects the eyelids or structures surrounding the eye. The patient will require an orbital exenteration as this malignant tumor would need to be excised to prevent metastatic spread (spread through the blood flow to other organs) and/or local extension.
This major surgery is undertaken when all other treatment options which allow the eyeball to remain intact in the hope of preserving vision, do not offer the best possibility of eliminating the tumor fully.
Judicious oculoplastic surgeon Dr. Jennifer Hui provides eye care procedures to patients in Palm Springs, Palm Desert, La Quinta, Coachella Valley, Riverside, Redlands, Yucaipa, Loma Linda, and surrounding locations and neighborhoods in The Golden State.
The time taken for orbital exenteration procedure is around one hour. The surgeon usually performs this surgery under general anesthesia.
However, it can also be performed under deep sedation for elderly patients who are not considered to medically fit to receive general anesthesia. This procedure involves the removal of the eyeball, fatty tissues, and muscles surrounding the eye. It also includes removing a part of the eyelid as well.
In most cases, the socket is reconstructed using a split-thickness skin graft retrieved from the thigh area. The surgeon will prescribe regular post-op analgesic medications to the patient. A majority of patients can go home the same day or next day. The surgeon will assess the patient in one week, and they will also remove the dressing and external skin sutures at this time.
The surgeon will advise the patient to clean the skin in the incision area with cool, sterile water. The patient can wash the rest of the face normally. This socket is situated in the same area as air sinuses. Therefore, the patient should not blow their nose and restrict sneezing forcefully for six weeks following the procedure.
This will limit the risk associated with air entry into the socket and secondary infection. Lastly, inflammation and bruising resolve faster if the patient sleeps with their head in an upright position using extra pillows for around two weeks.
Complete recovery after an orbital exenteration may take several months. The healing process will cause the socket to appear hollow, and the area surrounding it will feel tauter. The aesthetic appearance can be improved by placing an ocular prosthesis made from silicone and similar to the other eye.
This prosthesis can be fixed to a pair of glasses or attached to the socket via special magnetic implants. A specialist crafts these prostheses intricately and they usually offer a very acceptable cosmetic appearance to the patient. All orbital exenteration patients require routine clinical review for up to five years.