High-dose radiation to the orbit. A cause of skin graft failure after exenteration.

Two patients had orbital exenteration for recurrent basal cell carcinoma after multiple courses of radiation to the orbit. Postoperatively, there was sloughing of skin graft from the bony surfaces that received the highest exposure to the radiation, presumably secondary to death of soft-tissue elements within the bone. Incidentally, epithelialization of these areas secondarily by granulation failed to occur. The result was permanent denuding of large areas of orbital bone.