title: Orbital reconstruction after eyelid- and conjunctiva-sparing orbital exenteration.
abstract: OBJECTIVE
  To describe the technique and results of eyelid- and conjunctiva-sparing orbital exenteration with temporalis transfer and dermis-fat graft.
  
  
  METHODS
  Five patients who underwent this procedure were studied, based on retrospective chart review. Schematic drawings were produced to illustrate the surgical technique.
  
  
  RESULTS
  The study included three female and two male patients with an age range of 7 to 76 years. Two patients required surgery for invasive optic nerve sheath meningioma, one for hemangiopericytoma, and the fourth for mesenchymal chondrosarcoma. The last patient had eyelid-sparing exenteration performed more than 20 years earlier for retinoblastoma and underwent a similar reconstruction. One case was complicated by infection and graft atrophy. The remaining four cases retained orbital volume and eyelid structures with a reasonable cosmetic outcome. Average follow-up period was 21 months, during which one patient had development of intracranial meningioma at the proximal end of the optic canal.
  
  
  CONCLUSIONS
  Eyelid- and conjunctiva-sparing orbital exenteration with temporalis transfer and dermis-fat graft is a useful technique that minimizes the usual deformity and achieves good results. Case selection is emphasized, as this technique is mainly reserved for histopathologically benign orbital lesions that exhibit local aggressive behavior and for malignant lesions only if there is no eyelid, lacrimal gland, or orbital fissure involvement nor significant conjunctival or deep extension of an intraocular tumor.
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, Canada.
authors.forename: Audrey
authors.initials: A
authors.lastname: Looi
authors.forename: Michael
authors.initials: M
authors.lastname: Kazim
authors.forename: Maria
authors.initials: M
authors.lastname: Cortes
authors.forename: Jack
authors.initials: J
authors.lastname: Rootman
mesh_terms: D000328:Adult; D000368:Aged; D002648:Child; D003228:Conjunctiva / Q000601:surgery*; D005134:Eye Neoplasms / Q000601:surgery; D005143:Eyelids / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017233:Orbit Evisceration; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps