Endoscopic transconjunctival surgical approach to intraconal space of the orbit: first clinical experience

Abstract

Background and purpose: Recently, a transconjunctival, endoscope-assisted (TEA) approach to the medial intra-orbital space was developed based on cadaver preparations, with an ultimate goal of minimizing disturbances of the anatomic structures of the orbit. However, no report on clinical validation of this promising technique was published thus far. We present our experiences with the TEA approach in two patients.

Material and methods: In emergency conditions, we approached the lateral retrobulbar space of a 42-year-old male through a 180° incision close to the corneal limbus; a scrap of metal, which had perforated the globe and resided at its posterior wall, was removed endoscopically. Moreover, we used the TEA approach to remove a tumor from the upper intraconal space in a 63-year-old woman.

Results: In both patients the surgical goal was achieved with no muscle transection and without additional morbidity and complications.

Conclusions: Our experiences with TEA approach suggest that the procedure is clinically feasible, produces no co-morbidity and yields good functional and cosmetic results. As a result, the whole circumference of the retrobulbar space can be conveniently explored.

Keywords: Endoscopy; Intra-orbital pathology; Orbit; Surgical approach; Transconjunctival approach.