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Lower eyelid - transconjunctival

Transconjunctival lower-eyelid approaches

Overview

Transconjunctival lower-eyelid approaches are performed in several ways.

A) Transconjunctival (inferior fornix transconjunctival using a retroseptal or preseptal route)
B) Transcaruncular (=medial transconjunctival)
C) Transconjunctival with lateral skin extension (lateral canthotomy/”swinging eyelid”)
D) Combination of inferior (A) and medial (B) transconjunctival
E) C-shaped incision (ie, Combination of inferior (A) and medial transconjunctival (B) plus lateral skin extension (C))

The advantage of transconjunctival incisions is the superior cosmesis due to lack of a cutaneous scarring. A disadvantage maybe a limited access of non-extended or non-combined approaches in comparison to lower-eyelid skin incision.