Case series of subtotal exenteration with buccal mucosal graft for orbital squamous cell carcinoma.

Abstract

The aim of the study was to look for a safe alternative to a disfiguring total orbital exenteration for orbital squamous cell carcinoma, so that a standard hospital issue inexpensive stock ocular prosthesis can be fitted with improved aesthetic results, rather than an expensive custom made prosthesis for the patient’s own cost. The subjects and methods involved a retrospective case review which was performed of patients from St Aidan’s Missionary Hospital initially, which was later amalgamated into the McCords Provincial Eye Hospital, Durban, KwaZulu-Natal, South Africa. Ten consecutive patients who underwent an ‘extended’ lid-sparing subtotal exenteration with minimally preserved healthy conjunctiva and a buccal mucosal graft were identified over a 3 year period from 1 January 2011 to 31 December 2013. Patients’ clinical records were reviewed. Results included all of the ten patients having a good aesthetic outcome at 4 weeks and six months with a standard hospital issue stock ocular prosthesis. One patient had a repeat buccal mucosal graft after forniceal shortening. Three patients had local recurrences within one year but all recurrences were identified easily and total exenteration was successfully performed. The survival rate at 3 years was ninety percent as one patient was lost to follow-up. A subtotal orbital exenteration with minimally preserved healthy conjunctiva and a buccal mucosal graft is cost effective, safe and cosmetically acceptable with a standard ocular prosthesis.