J Neurol Surg B Skull Base 2020; 81(04): 422-434
DOI: 10.1055/s-0040-1713849
Surgical Approaches to the Orbit
Review Article

Transconjunctival and Transcaruncular Approaches to the Orbit

Natalie Wolkow
1  Department of Ophthalmology, Ophthalmic Plastic Surgery Service, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
,
Suzanne K. Freitag
1  Department of Ophthalmology, Ophthalmic Plastic Surgery Service, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
› Author Affiliations

Abstract

Transcaruncular and transconjunctival approaches are commonly used by ophthalmic plastic surgeons to access various orbital compartments. These approaches are versatile and may be combined with transnasal or transcranial approaches to the orbit to gain optimal access to challenging locations. A major advantage of the transcaruncular and transconjunctival approaches is the lack of a visible skin incision with excellent postoperative cosmesis. As with all orbital surgery, an in-depth knowledge of orbital anatomy and physiology, as well as meticulous hemostasis, is needed to prevent complications including globe injury, permanent vision loss, diplopia, and retrobulbar hemorrhage. This article reviews the surgical steps of these approaches. The indications for each approach and case examples are illustrated.



Publication History

Publication Date:
09 September 2020 (online)

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