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February 1950


Arch Ophthalmol. 1950;43(2):376-377. doi:10.1001/archopht.1950.00910010383016

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To the Editor.  —The recent paper "Operation for Ptosis Utilizing the Superior Rectus Muscle," by Dr. R. N. Berke, which appeared in the December issue of the Archives, brings to mind an anatomic relationship of importance in the performance of many operations of the Motais type, and one which, to the best of my information, has not previously been mentioned.The correction of ptosis in these operations, according to Shoemaker (Ann. Ophth. 1907), in an opinion concurred in by Spaeth, is brought about by establishing an adhesion between the lid and a fixed position on the globe. This position in many of the modifications of the Motais operation, such as Berke's ingenious operation and the Dickey fascia lata sling procedure, is established at or near the insertion of the superior rectus.If, for example, the lid were anchored by adhesion between the upper border of the tarsus and the insertion

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