Dr.Santosh G Honavar, Dr. RAKSHA RAO, Mr.Chalamala Jangaiah, Gangadhar Jalli
Orbital exenteration is often performed as a life-saving measure for eyelid, ocular surface and intraocular tumors with orbital extension, and for primary orbital tumors or infections such as mucormycosis where conservative treatment is not feasible. Following orbital exenteration, challenge lies in providing a customised orbital prosthesis. A good surgical technique is essential to provide a concave, smooth and stable skin cover, over which an orbital prosthesis can be glued-on.
This method, described by Coston and Small, is a modification of the total exenteration technique, and spares parts of both the eyelids, with transverse blepharorrhaphy to cover the orbit, and ensures better cosmesis and early rehabilitation. In addition, sparing of the orbicularis muscle provides an excellent vascular supply to the skin flap. This video demonstrates the eyelid-sparing technique in a patient with orbital extension of conjunctival squamous cell carcinoma.