University of Iowa Health Care

Ophthalmology and Visual Sciences

Transcutaneous Inferior Anterior Orbitotomy

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This is Richard Allen at the University of Iowa.  This video demonstrates the use of a transcutaneous incision to access a lesion that situated in the inferior extraconal space. 

4-0 silk suture is placed through the eyelid margin to provide traction during the case. 

A 15 blade is then used to make an incision through the skin. 

Westcott scissors are used to dissect between the orbicularis muscle and orbital septum. 

The lesion is identified relatively easily and lies just posterior to the orbital septum. 

Dissection is carried out with both Westcott scissors and a Freer periosteal elevator. 

This lesion actually proved to be a sarcoma. 

Hemostasis is obtained with a bipolar cautery. 

Due to the concern for post-operative bleeding, a drain is placed. 

The transcutaneous incision is then closed with a running 6-0 Prolene suture. 

At the conclusion of the case, antibiotic ointment is placed over then incision and the drain is removed on the following day. 

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last updated: 04/27/2015
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