While akinesia is important in every form of cataract operation, it has demonstrated its worth particularly in the intracapsular procedure, as control of the eyelids is essential to the safety of the operation. Smith made an important contribution to the intracapsular technic by devising a method of retracting and controlling the lids with the aid of a specially trained assistant, which was described as follows: On completion of the section, the speculum was removed; the upper lid was drawn forward from the eyeball with a large, blunt-tipped tenotomy hook, and with the fourth and fifth fingers of the same hand, the eyebrow was pushed up, so that the orbicularis action was controlled. The lower lid was pulled down with the index finger of the other hand. This maneuver was then simplified with the use of the Fisher retractors.
A look at the past . . . Arch Ophthalmol. 2000;118(7):910. doi:10-1001/pubs.Ophthalmol.-ISSN-0003-9950-118-7-eya00007
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