University of Iowa Health Care

Ophthalmology and Visual Sciences

Transconjunctival anterior orbitotomy for inferior lateral mass

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This is Richard Allen at the University of Iowa.  This video demonstrates the use of a transconjunctival incision to access an extraconal inferior lateral mass. 

A monopolar cautery is used to make an incision inferior to the inferior boarder of the tarsus. 

Dissection is then carried out between the orbicularis muscle and orbital septum inferiorly.

The area of the lesion is identified which lies posterior to the orbital septum. 

A 4-0 silk suture is then placed through the conjunctival edges. 

The orbital septum is then opened with Westcott scissors. 

The lesion has the gross appearance of a lymphoma, which was confirmed by the pathologist. 

The lesion is biopsied with Westcott scissors and sent to immuno as well as ocular pathology. 

Hemostasis is obtained with the monopolar cautery. 

In this case a lateral canthotomy and inferior cantholysis were not necessary. 

The transconjunctial incision is closed with interrupted 7-0 vicryl sutures. 

At the conclusion of the case, antibiotic ointment is placed into the eye and the patient returns in approximately one week. 

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last updated: 04/27/2015
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