transkonjunktival

Transconjunctival, also spelled transkonjunktival in some languages, is an adjective used in medicine to describe a route, incision, or approach that passes through the conjunctiva, the thin mucous membrane covering the inside of the eyelids and the anterior surface of the eye. In ophthalmology and oculoplastic surgery, transconjunctival approaches are used to access orbital, eyelid, and vitreoretinal structures without external skin incisions.

The most common applications are in orbital surgery and eyelid procedures. For orbital floor fractures, a transconjunctival inferior fornix incision provides access to the infraorbital rim and orbital floor, allowing fracture reduction and implant placement with no visible external scar. This approach offers favorable cosmetic results and direct visualization of the orbital rim but requires careful dissection near the lacrimal system and extraocular muscles. In eyelid surgery, transconjunctival approaches underpin scarless lower eyelid procedures, including blepharoplasty and canthoplasty, by avoiding external skin incisions.

In vitreoretinal surgery, transconjunctival techniques use small-gauge instruments that enter the globe through the sclera via the conjunctival surface, enabling sutureless vitrectomy. This transconjunctival access has become standard in modern microincisional vitrectomy surgery, reducing tissue trauma and improving recovery.

Advantages of transconjunctival approaches include the avoidance of external facial scars, shorter recovery, and good cosmetic outcomes. Potential drawbacks include conjunctival scarring, limited exposure in some cases, and risks to the lacrimal drainage system or extraocular muscles.

The term derives from the Latin trans- through and conjunctiva. In practice, the exact technique varies by procedure and surgeon preference.