Fourteen years ago Meyer Wiener1 described an ingenious procedure to correct the pronounced divergence resulting from third nerve paralysis. As he stated, Edward Jackson and Dransart had, unknown to him, suggested a similar procedure and performed it on cadavers but not on patients with third nerve paralysis. Wiener's procedure included weakening the external rectus and transplanting the superior oblique muscle to an attachment beneath the insertion of the internal rectus muscle. He approached the superior oblique on the globe after cutting the superior rectus muscle, which was later replaced. The tendinous portion of the muscle was followed to the pulley, and with a scalpel the pulley was cut, the muscle being freed. The tendon was severed from the globe and the muscle dissected back into the orbit. About ½ inch (1.3 cm.) of tendon was cut off, and the end was sutured beneath the insertion of the internal rectus
GIFFORD SR. TRANSPLANTATION OF SUPERIOR OBLIQUE MUSCLE FOR OCULOMOTOR NERVE PARALYSIS. Arch Ophthalmol. 1942;28(5):882–890. doi:10.1001/archopht.1942.00880110130011
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