INTRODUCTION:

The illustrations show a special surgical technique to correct the muscles of the eye.
With consideration of the anatomic course of the vessels of the conjunctiva bulbi and the anterior ciliary vessels, the conjunctiva is incised horizontally, instead of the usual vertical approach as the vascular supply also follows a horizontal orientation. The muscle insertion is exposed and the vessels cauterised.
The incision begins 1 mm from the limbus and ends at the upper part of the plica semilunaris.
The insertion is dissected with a scleral “self edge”, producing a strong muscle border, facilitating the liberation of the muscle itself. After the two “wings” of the muscle have been slit, the muscle tendon is exposed and a squint hook can now be inserted. After dissecting the tendino-scleral end of the muscle, sutures are placed and the muscle is sutured 6 mm behind the original attachment at the episclera. The individual steps of the operation are illustrated with pictures.