Orbit: Orbital Exenteration with Split-Thickness Skin Graft

Exenteration is surgical removal of the orbital contents, including the globe, ocular adnexa, and eyelids. The eyelids may be spared in certain circumstances and used to line the exenteration cavity. It is usually indicated for invasive or devastating orbital neoplasms (primary or secondary from adjacent structures) or the treatment of angioinvasive fungal infections. The exposed orbital walls may be left to heal spontaneously, by granulation tissue or covered with a split-thickness skin graft. Given the radical nature of exenteration with a significantly associated cosmetic penalty, patients must be extensively counseled preoperatively regarding the necessity of the procedure and its potential drawbacks.