Abstract

ABSTRACT Purpose To describe a transconjunctival technique for full-thickness (excisional) optic nerve biopsy. Method A medial transconjunctival approach to the optic nerve with disinsertion of the medial rectus is used. A small right-angle Mixter forcep is used to clamp the optic nerve far posteriorly, and then a microscalpel is directed metal-on-metal to cut the posterior optic nerve. The cut nerve is then rotated anteriorly to complete the proximal nerve cut. Result A full-thickness specimen of 11 mm of more can be obtained without undue traction on the globe. The globe remains viable. Conclusion A long length, excisional optic nerve biopsy can be readily and safely performed without endoscopic techniques.

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