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I should like to recommend the following corneoscleral suture with modified conjunctival flaps.
A conjunctival incision is made along the limbus from 11 to 1 o'clock (figure, A). This part of the conjunctiva is then undermined
From 1 to 3 o'clock a conjunctival flap 3 mm. wide is prepared. A similar one is made from 11 to 9 o'clock (figure, B).
2. A single-armed 000000 silk suture is knotted double. The needle is then introduced into the conjunctiva above 12 o'clock, about 5 mm. from the limbus, from without in. A vertical bite is then taken in the episclera 2 mm. above the limbus, the needle emerging as close as possible to the limbus. The needle is then reintroduced through the conjunctiva 2 mm. above the free border and brought out. This needle is then cut off. The suture is now anchored above in the episclera and outside the conjunctive.
SPERO GD. A NEW SHOESTRING CORNEOSCLERAL SUTURE. Arch Ophthalmol. 1949;42(4):463-464. doi:10.1001/archopht.1949.00900050471013