Teachers of ophthalmic surgery have long advocated the more frequent performance of advancing and shortening operations, and some do them exclusively in preference to tenotomy for strabismus, but I believe that most of us are still very largely doing tenotomies. It must be that none of the various methods of advancement are considered entirely satisfactory, the simpler operation of tenotomy being more frequently chosen, hoping thereby to obtain an acceptable result.
Most ophthalmologists will agree that the advancement operation is more certainly corrective, physiologically more scientific, and functionally safer than tenotomy, and it is my conviction that a tenotomy alone should rarely be done in any case of squint.
A rather extensive observation of the work of various operators, including repeated visits to many of the large European eye clinics, convinces me that the ideal advancement operation has not yet been presented. There are certain requisites for this ideal
HULEN VH. THE ADVANCEMENT OPERATION IN SQUINT. JAMA. 1910;55(2):123–126. doi:10.1001/jama.1910.04330020027009
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