The Superior-Medial Lid Crease Orbitotomy: A Photoessay

The superior-medial lid crease approach to the intraorbital optic nerve may be easier to learn, less technically challenging and better able to provide wider surgical exposure than other traditional transorbital surgical approaches. Our experience with this recently described and less well-known technique authored by Pelton and Patel is more limited than with other traditional approaches. Yet, we believe the standard approaches (medial transconjunctival, medial transcaruncular, and lateral transcutaneous with/without bone flap) are more technically difficult, more time consuming, more restricted by a tighter working space, and more limited with respect to degree of exposure of the optic nerve compared to the superior-medial lid crease approach.