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I was led to attempt to devise new methods of shortening and advancing ocular muscles, first, by the great variety of such methods, indicating that no one is entirely certain of results, and, second, by the constant repetition of the necessity for marked overcorrection to allow for subsequent slipping.
The great defect in all methods of which I have seen descriptions is that the sutures are under the elastic pull of the muscle, thus violating one of the important principles of surgery in relation to suturing. The problem, then, is to devise methods in which either (1) no suture—in the sense of being employed to hold two parts together—is used, or in which (2) if such sutures are used, they are so supported as to be under no tension. At first thought one is tempted to believe that the above propositions are impossible but, in my opinion, the methods here
O'CONNOR RP. SHORTENING AND ADVANCEMENT METHODS WITHOUT EMPLOYING SUTURES UNDER TENSION. JAMA. 1912;LVIII(9):626–627. doi:10.1001/jama.1912.04260030026009
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