AIM: To analyze the clinical effect of different surgical approaches for orbital tumors.

METHODS: A total of 52 patients(56 eyes)with orbital tumors who were admitted to the hospital from January 2012 to June 2017 were examined by brain MRI and orbital sectional CT scan to identify the relationship between tumors and surrounding anatomical structures. They were treated by orbitotomy, and the approaches included anterior conjunctival approach, lateral approach and combined medial and lateral approach. The removal of tumors, recovery of visual acuity, postoperative early complications and follow-up recurrence were statistically analyzed.

RESULTS: Among the 52 patients, there were 7 cases 8 eyes(14%)with residual tumors. The rate of residual tumors after anterior conjunctival orbitotomy(23%)was higher than that after lateral orbitotomy or combined medial and lateral orbitotomy(6%, 7%; P<0.05). The visual acuity was improved in 28 cases 30 eyes(54%), no change in 18 cases 19 eyes(34%)and decreased in 6 cases 7 eyes(13%). The incidence of early complications was 23%, including 2 cases 2 eyes with accidental loss of vision, 2 cases 2 eyes with pupil changes, 3 cases 3 eyes with ptosis and 5 cases 6 eyes with eye movement disorders, which mainly occurred in the elderly. The recovery of visual acuity and the incidence rates of complications(23%, 19%, 29%)of the three kinds of surgical approaches were close(P>0.05). During the follow-up period, there were 3 cases 3 eyes(5%)with recurrence in the 52 patients, and the recurrence rate after combined medial and lateral orbitotomy(14%)was significantly higher than that after anterior conjunctival or lateral orbitotomy(4%, 0; P<0.05).

CONCLUSION: The appropriate surgical approach can successfully remove the orbital tumors, improve or stabilize the visual function, and reduce complications and recurrence.