Scleral shortening has long been done by excising and discarding a biconvex or a crescentic section of the outer portion of the sclera over a more or less greater part of the circumference.
The following method preserves and uses the outer portion of the sclera rather than discarding it and thereby produces a more secure shortening according to fundamental surgical techniques. It is well known that the halving technique of uniting tissue edges, as popularized by Wheeler, provides a better method of union than edge-to-edge approximation, because of the increased area of the raw surfaces which must grow together.
The following technique utilizes the above-mentioned principles: The usual conjunctival incision is made well back from the limbus in the desired area, and the sclera is cleaned. The usual care in relation to the emissary veins is exercised, and an incision perpendicular to the surface of the sclera is made through
HUGHES WL. Overlapping Technique to Produce a Scleral Fold. AMA Arch Ophthalmol. 1958;60(3):502-504. doi:10.1001/archopht.1958.00940080520027