Purpose

1. To estimate the number of exenterations done in KKESH during the period 1999-2025
2. To list the indications of the procedure.
3. To evaluate the outcomes in terms of patient survival and rehabilitation.
4. To report the final pathological diagnosis of the tissue.

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Methods

Single-center retrospective study that reviewed patients who underwent orbital exenteration between January 1999 and December 2025 at King Khaled Eye Specialist Hospital (KKESH). Patients demographics, presenting complaints, radiography, histopathology, type of exenteration, local recurrence, metastases, survival, and treatment data were recorded.

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Results

Fifty-four patients (Malignant tumors in 51 cases, mucormycosis, schwannoma and traumatic phthisis bulbi each in 1 case) were included.
Squamous Cell Carcinoma (N=32) followed by retinoblastoma and basal cell carcinoma (each N=5) were the most common indications for exenteration.
The most common malignancy location was the conjunctiva (N=30) followed by the lower lid (N=5) and the retina (N=5).
The earliest recurrence after exenteration was around 4 months, and latest was 97 months.
Survival rates were (90.1%) at 1 year, (45.5%) at 3 years, and (31.3%) at 5 years.

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Conclusion

Orbital exenteration remains a necessary intervention for advanced periorbital malignancies. Conjunctival SCC was the predominant indication in our series, consistent with high-UV-exposure regions globally. Internationally, SCC constitutes the most common histopathological diagnosis across exenteration series. Survival rates of 90.1%, 45.5%, and 31.3% at one, three, and five years respectively are comparable to, though slightly lower than, the 50% five-year survival reported in a recent large meta-analysis, likely reflecting late-stage presentation in our cohort. The broad recurrence window underscores the need for long-term surveillance. A multidisciplinary approach incorporating adjuvant radiotherapy remains essential to optimize outcomes.

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Additional Authors

First name	Last name	Base Hospital / Institution
Maram	Alnefaie	King Khaled Eye Specialist Hospital (KKESH)
Shahad	Alruweili	King Khaled Eye Specialist Hospital (KKESH)
Humoud	Alotaibi	King Khaled Eye Specialist Hospital (KKESH)

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