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This operation is submitted as my modification of Prince's advancement operation, particularly regarding the insertion of the suture in the tendon of the muscle.
A vertical incision is made in the conjunctiva about 6 mm. from the limbus. After the conjunctiva is undermined up to the limbus and over the tendon of the muscle, Tenon's capsule is buttonholed at one side of the tendon, a strabismus hook is inserted under the tendon, and Tenon's capsule is incised on each side but not stripped from over the tendon. A Prince's advancement forceps is now applied near the insertion of the tendon, with the handle of the forceps toward the cornea, and the tendon is cut close at its insertion.
I use a double-armed suture of 000 ten day chromacized catgut and substitute for one of the atraumatic needles (which come with the suture) a Jameson needle to be used in
Hunt GA. A SINGLE SUTURE ADVANCEMENT OPERATION. Arch Ophthalmol. 1937;17(1):135–136. doi:10.1001/archopht.1937.00850010147011
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