Superonasal Transconjunctival Optic Nerve Sheath Decompression (stONSD)

This is a modification of the standard medial transconjunctival approach to optic nerve sheath decompression that uses 4-0 silk bridle sutures around the superior and medial rectus muscles without disinsertion of any extraocular muscles. The orbital retractor used is the Farris-Tang orbital retractor (Bausch & Lomb, #SP7- 53436). Rhoton spatula dissectors (V. Mueller, part #NL 3785-006) are used for blunt exposure of the dural sheath and for lysing subarachnoid adhesions, and the dural window is created wit