Radial optic neurotomy using nasal and temporal approach incisions: histopathologic study in human cadaver eyes.

Michael Altaweel // Publications // Nov 01 2007

PubMed ID: 17998516

Author(s): Altaweel MM, Freisberg L, Pal N, Gleiser J, Ryan EH, Dawson D, Albert D. Radial optic neurotomy using nasal and temporal approach incisions: histopathologic study in human cadaver eyes. Arch Ophthalmol. 2007 Nov;125(11):1553-7. PMID 17998516

Journal: Archives Of Ophthalmology (Chicago, Ill. : 1960), Volume 125, Issue 11, Nov 2007

OBJECTIVE To examine the structural effect of radial optic neurotomy (RON) using nasal and temporal approach incisions on the nasal side of the optic nerve (ON) using dominant and nondominant hands in human cadaver eyes.

METHODS Transvitreal RON was performed in 9 eyes with a microvitreoretinal blade by a right-handed surgeon. A nasal approach was used in 4 left eyes (using the right hand) and in 2 right eyes (using the left hand), and a temporal approach was used in 3 right eyes (using the right hand). Histologic sections were examined for depth of nerve penetration and for effect on critical structures.

RESULTS The scleral canal was fully incised in all cases. The mean depth of nerve penetration was 555 micro25 microing the nasal approach and 246.7 microing the temporal approach) (P =.12). The globe was not ruptured in any eye. In a single right eye approached temporally using the right hand, the adventitial sheath of the central retinal artery was lacerated.

CONCLUSIONS RON in human cadaver eyes results in lysis of the scleral canal at the ON head. Greater depth and improved safety of incision can be achieved by always approaching the incision from the nasal side of the ON using the dominant or nondominant hand.