Tenon's capsule

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The Tenon's capsule (synonyms: Tenon's capsule , vagina bulbi ) is part of the ligamentous apparatus of the eyes and a connective tissue-like fascia located in the human eye socket ( orbit ) . The capsule is named after the French surgeon Jacques-René Tenon (1724-1816), who first described the structure in 1806.

anatomy

Periorbita and eye fascia (red)

Tenon's capsule separates the sclera from the orbital fat tissue . On the front, the capsule is about 2 millimeters behind the limbus , on the back in the area of ​​the optic nerve outlet with the sclera. All nerves , muscles and blood vessels pass through Tenon's capsule. While the vortex veins and ciliary vessels receive a kind of fixation at their entry points, there are so-called gates in the eye muscles , which allow the muscles a certain range of motion. Several sliding surfaces (Spatium episclerale) allow both limited mobility of the eyeball within the capsule and movement with the capsule within the surrounding tissue. The comparison of the eyeball with a joint head and Tenon's capsule with a joint socket is therefore only very imprecise. In the area of ​​the globe equator, Tenon's capsule merges into a ring band of dense fibers, the cingulum bulbi .

Clinical relevance

In reconstructive eye surgery, the fascia-like structures of Tenon's capsule, also known clinically as Tenon's, are suitable for replacing the conjunctiva after severe burns or adhesions ( symblephara ) in autoimmune processes. They are able to epithelialize quickly (to gain surface layer). So-called Tenon's leaves are pulled forward from the depth of the orbit and attached to the limbus (the border with the cornea). Pioneering work and the establishment of the surgical principle ( Tenon sculpture , 5-113.3) was done by Martin Reim (* 1931), em. Director of the University Eye Clinic Aachen.

In fistulating glaucoma surgery, special consideration is required for the Tenon. Very prominent filter pads that flap the cornea are due to poor adaptation of the tenon to the limbus . Tenon's cysts, usually very prominent, can jeopardize the pressure-lowering success of fistulating glaucoma operations. There is also evidence that removing the Tenon may lead to better success rates.

See also

literature

Individual evidence

  1. ^ Gert-Horst Schumacher , Gerhard Aumüller : Topographische Anatomie des Menschen. 7th edition. Elsevier, Urban & Fischer, Munich et al. 2004, ISBN 3-437-41367-8 , p. 96, (online) .
  2. ↑ OPS operations and procedure key
  3. ↑ Ch. Teping, M. Reim: Tenon's plasty as a new operating principle in the early treatment of the most severe burns * . In: Clinical monthly sheets for ophthalmology . tape 194 , no. January 01 , 1989, ISSN  0023-2165 , pp. 1–5 , doi : 10.1055 / s-2008-1046325 ( thieme-connect.com [accessed December 12, 2017]).
  4. ↑ J. Howlett, K. Vahdani, J. Rossiter: bulbar conjunctival and Tenon's Layer Thickness Measurement using Optical Coherence Tomography . In: J Curr Glaucoma Pract . tape 8 , no. 2 , May 2014, p. 63-66 .
  5. ↑ A. Awadein, YM El Sayed: Excision of Tenon Capsule in Pediatric Trabeculectomy: A Controlled Study . In: J Glaucoma . tape 25 , no. 1 , January 2016, p. 39-44 .