We have already published Small incision Fascia lata harvesting and small incision external dacryocystorhinostomy based on our sliding theory. The aim of this study is to demonstrate (Film) and report the results of small incision lateral orbitotomy based on sliding theory.

Patients with different intra-orbital lesions who were scheduled for lateral orbitotomy procedure were included from September 2013 to March 2016. Lateral crows’ feet incision (5 mm lateral to lateral canthal angle) of 12-15 mm was made. The exposure was 3-4 times more than the size of incision using two-hand approach with sliding the incision site into different directions. Lateral orbital rim was sawed and removed, lateral orbital was removed, periorbita was opened, lateral rectus muscle was fixed, intra-conal lesion was totally removed or biopsied, orbital rim was screwed back to its normal position, periosteum was sutured, subcutaneous tissue was sutured, and skin was closed with 3 interrupted 6-0 nylon suture. All the procedures were performed using a good illumination (head light) and hemostasis by one oculofacial plastic surgeon.

There were 18 patients included. Cavernous hemangioma (10), Schwannoma (2), Dermoid cyst (2), and orbital inflammatory lesion (4) were the orbital lesions. No intraoperative and post-operative complications were observed. Incision sites were healed up with no visible scar within 4-6 months after the procedure.

Sliding theory could be implemented for lateral orbitotomy procedure by making the incision length shorter. Similar to small incision Fascia Lata harvesting and External Dacryocystorhinostomy, sliding theory- based small incision lateral orbitotomy offers a surgical field of 3-4 times more than incision site. It also results in a faster recovery and a better cosmesis after the surgery.