Optic nerve sheath fenestration through a lateral canthotomy incision

Area of Science:

• Ophthalmology
• Neurosurgery
• Surgical Techniques

Background:

• Optic nerve sheath fenestration (ONSF) is a surgical procedure to relieve visual loss from optic disc pathologies.
• Traditional ONSF approaches include medial (with medial rectus muscle disinsertion) or lateral (with lateral orbital rim removal).
• These methods present challenges in surgical access and potential complications.

Purpose of the Study:

• To describe a novel surgical technique for ONSF using a lateral canthotomy incision.
• To evaluate the feasibility and advantages of this new approach for accessing the retrobulbar optic nerve.

Main Methods:

• A lateral canthotomy incision was utilized to access the retrobulbar optic nerve.
• This technique avoids the need for extraocular muscle disinsertion or orbital bone removal.
• The procedure was performed on 17 eyes in 14 patients.

Main Results:

• The lateral canthotomy approach provided ready surgical exposure of the optic nerve.
• This technique was successfully applied in 17 eyes across 14 patients.
• It combines the benefits of lateral optic nerve exposure with the operational simplicity of the medial approach.

Conclusions:

• The lateral canthotomy incision offers a safe and effective alternative for ONSF.
• This technique simplifies surgical access to the optic nerve, potentially reducing operative morbidity.
• It represents an advancement in surgical management for conditions causing optic nerve compression and visual loss.