EYE BANKING - TECHNIQUES FOR EYE PRESERVATION IN SELECTED NEOPLASMS ENCROACHING ON THE GLOBE

Removal of the globe and associated structures has been advocated for tumors invading the periorbital bone and periosteum, orbital fat, or e xtraocular muscles. In some patients with cancerous tumors encroaching on the globe, however, it may be possible to remove the tumor and sav e the eye. Tenon's fascia is a firm fibrous sheath surrounding the ent ire globe except the cornea. If the neoplasm spreads along fascial pla nes rather than through them, and if this layer remains free of tumor involvement, preservation of the globe can be considered. Oculoplastic reconstructive techniques may limit exposure and diplopia. allowing t he eye to be ''banked'' in vivo, and saved as a spare for the future. Six patients with malignant tumors encroaching on the globe have had d efinitive surgical extirpation with preservation of the eye. Three pat ients have had the globe uncovered successfully. Five of six patients remain disease-tree, with followup from 6 months to 6 years. No globes have been removed. These techniques appear to be therapeutically soun d, preserve function and appearance, and improve patient morale. The i ndications and limitations of this approach to certain cases of perior bital cancer are discussed.