CASE REPORT article
Front. Ophthalmol.
Sec. Oculoplastics, Orbit and Trauma
This article is part of the Research TopicInsights in Orbit, Oculoplastics, and TraumaView all 6 articles
Exploring Orbital Exenteration in Survival Amongst Patients with Severe Rhino-Orbital-Cerebral Mucormycosis: A Case Series
Provisionally accepted
- 1USC Roski Eye Institute, Department of Ophthalmology, University of Southern California Keck School of Medicine, Los Angeles, United States
- 2Central Ohio Eye & Plastic Surgery, Nationwide Children’s Hospital, Department of Ophthalmology, The Ohio State University, Columbus, United States
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Rhino-orbital-cerebral mucormycosis (ROCM) is a rare, but fatal opportunistic fungal infection that can infiltrate local structures. Orbital exenteration (OE) is reserved for severe cases refractory to initial antifungal treatment and endoscopic sinus debridement, though there is currently no consensus on the ideal timing of OE and its impact on infection progression and survival. In this case series, we present three cases of similar, extensive ROCM that were candidates for orbital exenteration after initial medical and surgical management with variable outcomes. We discuss that orbital exenteration does not necessarily inform survival after ROCM infection and that the decision to proceed with exenteration should be personalized based on the status of a patient's comorbidities and the nature and region of infectious spread. Globe-sparing OE may serve as a viable alternative for patients with localized, late-stage infection or reversible ROCM risk factors given vision preservation and less postoperative disfigurement with possibly comparable efficacy.
Keywords: Orbital exenteration, Mucormycosis, Rhino-orbital, Invasive fungal sinusitis, Globe-Sparing, Retrobulbar amphotericin B
Received: 20 Aug 2025; Accepted: 27 Oct 2025.
Copyright: © 2025 Davuluru, Clark, Cahill, Foster, Chang and Zhang-Nunes. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Sandy X Zhang-Nunes, zhangnun@usc.edu
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