The authors evaluate their results when using gamma knife surgery (GKS) in the management of patients with vascular tumors and malformations of the orbit.

     Our purpose was to define indications and outcomes.

     The series included 53 male and 94 female patients with a mean age of 30.7±17.8 years (range 1.7–76 years).

     This is a retrospective clinical evaluation of 147 patients with vascular lesions of the orbit treated with GKS from Sep 1995 through Aug 2009. The diagnoses were based on pathological analyses in 59 patients, and presumed by characteristic clinical and radiographic findings in 88 patients. There were 53 nondistensible venous malformations, 35 cavernous hemangiomas, 27 orbital varice,11 arteriovenous malformations, 7 hemangioendotheliomas, 5 lymphangiomas, 5 hemangiolymphangiomas , 2 hemangiopericytomas , 2 arteriovenous fistulas. The tumor margin dose ranged from 12 to 20Gy. The median target volume was 5.6 cm3 (range 378.3mm3–30.2 cm3).

     At a median follow-up period of 28.5±13.4 months (range, 12 to 108 months), a decrease in lesion size was found in 138 patients (93.9%), and no lesion progression was observed after GKS. Visual acuity was preserved in 117 patients. 65 patients experienced some degree of visual sight improvement. Severe deterioration of visual acuity was found in 9 of 126 patients who had useful visual sight before treatment.

     This was a retrospective series.

     Gamma knife provides an effective management strategy in patients with vascular lesions of the orbit.

     Radiosurgery achives excellent neurological founction preservation and few treatment-related complications.