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Ocular and Orbital: Viewpoint—Surgery

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Principles and Practice of Stereotactic Radiosurgery

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Abstract

The bony orbit surrounding the eye is a unique anatomic space and is affected by similarly unique pathologic processes. These tumors and diseases may be amenable to stereotactic radiation; however, often they require surgical intervention commensurate with the distinctive nature of the anatomy and pathology. Tumors and inflammatory lesions of the orbit frequently require incisional biopsy to establish a diagnosis, while other masses may be excised entirely. These surgeries require very particular approaches to achieve the objective while protecting the eye and other important structures. Specifics regarding approaches to orbital surgery will be discussed below. Also discussed will be another surgery unique to the orbit termed enucleation or removal of the eye when it becomes blind and painful or is invaded by tumor. Some other ophthalmic diagnoses have been suggested in the past as targets for stereotactic radiosurgery, and these will be discussed as well. The high concentration of integral structures within the orbit confounds both surgical and radiotherapeutic approaches to many lesions and diseases. Given the small margin for error, stereotactic radiosurgery may prove to be a very useful adjunct to orbital surgery, and early experiences combining the expertise of orbital surgeons, neurosurgeons, and radiation oncologists have been encouraging.

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Authors and Affiliations

  1. Department of Ophthalmology, SUNY Upstate Medical University, 3400 Vickery Rd Suite A, Syracuse, NY, 13212, USA

    Bryant P. Carruth M.D. & Robert H. Hill M.D.

  2. Albany Medical Center, Albany, NY, USA

    Bryant P. Carruth M.D.

  3. Department of Ophthalmology and Otolaryngology, SUNY Upstate Medical University, 3400 Vickery Rd Suite A, Syracuse, NY, 13212, USA

    Thomas A. Bersani M.D.

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  1. Bryant P. Carruth M.D.
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  2. Robert H. Hill M.D.
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  3. Thomas A. Bersani M.D.
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Correspondence to Bryant P. Carruth M.D. .

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Editors and Affiliations

  1. Department of Neurosurgery, SUNY Upstate Medical University, Syracuse, USA

    Lawrence S. Chin

  2. Dept. of Radiation Oncology, Univ. of Maryland School of Medicine, Baltimore, Maryland, USA

    William F. Regine

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Carruth, B.P., Hill, R.H., Bersani, T.A. (2015). Ocular and Orbital: Viewpoint—Surgery. In: Chin, L., Regine, W. (eds) Principles and Practice of Stereotactic Radiosurgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8363-2_63

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  • DOI: https://doi.org/10.1007/978-1-4614-8363-2_63

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