Background: Orbital exenteration, usually held in the neoplastic context, allows local control of the disease, but is a highly disfiguring procedure, with a high visual, psychological and social impact. Reconstruction of the orbit in this context has important aesthetic purposes – creating a pouch suitable for use orbital prostheses – and functional goals – cavity obliteration and creation of local conditions to the application of adjuvant therapies – constituting a unique challenge to the reconstructive surgeon.

Objective: Analyzing the clinical indications for orbital exenteration and reconstructive strategies developed in a major Portuguese Cancer Center.

Method: We retrospectively reviewed all patients undergoing reconstruction after orbital exenteration at Instituto Português de Oncologia-Porto, between January 2005 and January 2013.

Results: We present and analyze patient demographics, indications, reconstructive techniques and complications over 7 years. In all the cases local or regional flaps have been used.

Discussion and conclusions: The reconstructive strategies have been decided individually, depending on the extent of the defect, patient’s general condition and local and regional flaps availability. In all cases an adequate aesthetic and functional reconstruction of the exenterated orbit has been achieved.