RADIAL OPTIC NEUROTOMY TECHNIQUE
Radial Optical Neurotomy (RON) is a surgical technique that was developed with the goal of opening up and relieving pressure on the central retinal vein. This technique is used to in a number of procedures like CRVO (Central Retinal Vein Occlusion). Retinal vascular occlusive disease is the second most prominent cause of permanent retinal blindness.
It is shown that the optic disk’s anatomy, involving the scleral ring and the cribriform plate, contribute in the development of retinal vaso-oclussive diseases. The neurovascular compression within this confined space at this location plays a role in CRVO. Therefore, RON is performed to relieve the pressure on the central retinal vein that is lodged within this space.
The precursor to this procedure is called pars plana vitrectomy. After this the intraocular pressure (IOP) is elevated momentarily. A microvitreoretinal blade that is specially designed for this procedure is positioned at the edge of the optic disc and is directly posterior to the optic nerve, incising the lamina cribrosa and adjacent sclera.
One or, in very rare cases, two stabs are made, without any lateral movement of the blade. The surgeon takes great care in ensuring that the edge of the incision borders on, but does not touch the central retinal vessels. An immediate opening of the optic disc can be observed very often. The blade is then withdrawn and once it is withdrawn any small hemorrhages at the site of the procedure is controlled by the elevation of the IOP and use of a vitrectomy cutter for gentle tamponade.
This is a common procedure carried out in most major hospital and ophthalmology centers.
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