Transconjunctival Inferior-medial Anterior Orbitotomy
This is Richard Allen at the University of Iowa. This video demonstrates an anterior orbitotomy using a transconjunctival incision for a mass that is anterior, inferior, and medial.
4-0 silk sutures are placed through the eyelid margin for traction and an incision is made using the monopolar cautery inferior to the inferior boarder of the tarsus.
Dissection is then continued between the orbicularis muscle and the orbital septum inferiorly.
This will proceed towards the inferior orbital rim.
The mass is then palpated and visualized posterior to the orbital septum and has the gross appearance of a cavernous hemangioma which was confirmed by the pathologist.
4-0 silk sutures are then placed through the edge of the conjunctiva and the mass is then dissected free with the monopolar cautery and sent to the pathologist for evaluation.
Hemostasis is attained with the monopolar cautery.
The conjunctiva is the reapposed to the inferior boarder of the tarsus with interrupted 7-0 Vicryl sutures.
At the conclusion of the case, antibiotic ointment is placed in the eye and the patient returns in approximately one week.