The transconjunctival orbitotomy: A versatile approach to the orbit and beyond

Area of Science:

• Ophthalmology
• Surgical Oncology
• Oculoplastics

Background:

• Minimally invasive surgical approaches reduce operative trauma in orbital defect management.
• Bone- and canthal-sparing techniques with concealed incisions are preferred.
• Conjunctival access offers a versatile route for orbital procedures.

Purpose of the Study:

• To review the current knowledge on orbital entry via the conjunctiva.
• To highlight the efficacy and applications of transconjunctival orbitotomy.
• To discuss methods for expanding surgical access and potential complications.

Main Methods:

• Review of existing literature on transconjunctival orbitotomy.
• Description of surgical approaches through various conjunctival incisions (palpebral, forniceal, bulbar).
• Discussion of techniques to enhance surgical workspace, including eyelid tension release.

Main Results:

• The conjunctiva provides access to all orbital quadrants.
• Transconjunctival orbitotomy can be used as a standalone or combined procedure.
• Eyelid tension release techniques effectively expand the surgical field.
• Complications are primarily limited to dry eye disease.

Conclusions:

• Transconjunctival orbitotomy is a highly effective minimally invasive technique for orbital disorders.
• It allows comprehensive access to the orbit with minimal cosmetic impact.
• The procedure is adaptable for various lesion types and locations, with a low complication rate.