Descriptions of the various techniques of muscle recession in standard texts on strabismus and on ophthalmic surgery seem to agree on one point: they suggest that it is customary to sever the tendon from the globe before putting the muscle sutures into the sclera. The purpose of this communication is to indicate some of the advantages of leaving the disinsertion of the muscle until after the scleral sutures have been placed. The technique is standard practice for some surgeons but there is little if any record of it, hence the present note.
After the conjunctival incision, Tenon's capsule is opened at one border of the muscle, a squint hook is inserted and the capsule is then split backwards along both edges of the muscle for an appropriate distance. Attachments to the muscle from the conjunctiva are cut through. A second squint hook is temporarily inserted beneath the muscle and moved
ABRAMS JD. Late Disinsertion of the Muscle During the Recession Operation. Arch Ophthalmol. 1965;73(5):669-670. doi:10.1001/archopht.1965.00970030671015