Review of orbital exenterations in Korle-Bu Teaching Hospital

Background: Orbital exenteration (OE) is a disfiguring procedure which typically involves removal of the entire contents of the orbit including the periorbita, appendages, eyelids and, sometimes, a varying amount of surrounding skin and bone. It results in devastating functional, aesthetic and psychological losses. Design: This study reports an experience of OE in a Teaching Hospital in Accra Ghana. Method: The records of all patients who underwent OE between November 2005 and October 2009 were reviewed retrospectively. These were cases seen at the orbit and oculoplastic clinic of the eye unit. Results: A total of 25 patients underwent OE. Nineteen (76%) of these were for invasive orbital squamous cell carcinomas and six (24%) were for other cases. Only one patient had OE for a benign condition (orbital haemangioma). Four patients had lid sparing procedures. One of these was for a patient with extensive ocular surface squamous cell carcinoma. Five patients had recurrent tumours. Among those patients with squamous cell carcinoma, seven had previous procedures, sometimes multiple before reporting to our clinic. Conclusion: Orbital exenterations in developing countries are mostly for neglected periorbital and ocular surface malignancies. Educating patients to seek medical attention as soon as they notice a persistent conjunctival growth could prevent this.