Transconjunctival

Transconjunctival refers to a surgical approach or incision made through the conjunctiva, the mucous membrane that lines the inside of the eyelids and covers the anterior surface of the eyeball. The term is used primarily in ophthalmology and oculoplastic surgery.

Applications and uses: The transconjunctival route is common in lower eyelid procedures, such as transconjunctival lower blepharoplasty, where fat pads are accessed and adjusted via a conjunctival incision to address periorbital aging and contour irregularities without external skin incisions. It is also employed in certain orbital surgeries, including repairs of the orbital floor or infraorbital rim, where access to deep structures is gained through the conjunctiva to avoid external facial scars. In some settings, it may be used for lacrimal system or reconstructive procedures as part of broader orbital or eyelid operations.

Advantages: A primary benefit is the absence of visible external scars, contributing to favorable cosmetic outcomes. Preservation of the external lower eyelid skin and orbicularis muscle can reduce disruption to eyelid function and may lower the risk of external lid malpositions in selected cases. The conjunctival route can provide direct access to fat and certain orbital structures with a favorable cosmetic profile.

Limitations and risks: The approach requires technical precision and may have a steeper learning curve. Potential complications include conjunctival scarring, irritation or dryness, chemosis, and, less commonly, eyelid malposition such as entropion or ectropion. Adequate exposure may be limited compared with some transcutaneous approaches in certain anatomical situations.

See also: blepharoplasty, transcutaneous approaches, subciliary technique.