Japanese Journal of Ophthalmology

, Volume 61, Issue 4, pp 361–367 | Cite as

Upper fornix approach combined with a superior lateral cantholysis: a minimally invasive approach to the superonasal intraconal space

  • Ho-Seok SaEmail author
  • Ji Won Seo
  • Sunah Kang
Clinical Investigation



To present a new minimally invasive approach to the deep superonasal orbit.


This retrospective study reviewed seven consecutive patients who underwent orbital surgery using an upper conjunctival fornix approach combined with a superior lateral cantholysis for tumors in the superonasal intraconal space. Charts were reviewed for demographic, radiological, clinical, and surgical data including surgical outcome and morbidities for each patient.


Six benign tumors of the superonasal intraconal orbit were successfully exposed and removed using this approach, and one malignant tumor was biopsied for diagnosis. Histopathology revealed cavernous haemangioma (3 cases), solitary fibrous tumor (2 cases), schwannoma (1 case), and diffuse large B cell lymphoma (1 case). Visual acuity and ocular motility were unchanged or improved in all cases. There were no visible scars or other complications related to this approach.


The upper fornix approach combined with a superior lateral cantholysis is a novel technique that provides safe and excellent exposure of the deep superonasal orbit. In addition, it avoids the unnecessary morbidity of upper lid splitting, medial rectus muscle detachment, or bone removal.


Intraconal space Orbitotomy Superonasal orbit Transconjunctival approach 



Steven J. Yoon, M.D., Specialty Eye Care, Glendale, CA, USA for manuscript editing.

Conflicts of interest

H-S. Sa, None; J. W. Seo, None; S. Kang, None.

Supplementary material

Video. 1 Surgical steps of upper fornix approach combined with a superior lateral cantholysis are described. Surgical video and clinical course of illustrative case are also included (MP4 32729 kb)


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Copyright information

© Japanese Ophthalmological Society 2017

Authors and Affiliations

  1. 1.Department of Ophthalmology, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea
  2. 2.Department of Ophthalmology, Ilsan Paik HospitalInje University College of MedicineGoyangKorea

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