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In retraction of the lids for ocular surgery, more is involved than exposure of the eye. Generally it is essential for the lids to be held open in such a manner than no pressure is placed on the globe. Also, it is desirable from the point of view of asepsis to shield the operative wound from the lid margins, which are a potential source of infection. To achieve these objectives ophthalmic surgeons have used lid sutures, retractors, or selfretaining speculums, alone or in conjunction with orbicularis akinesia. Each method of retracting the lids has its advantages and disadvantages.
The lids can be retracted effectively by sutures placed in the skin at the palpebral margins; however, this requires infiltration of the lids with a local anesthetic. Some edema and hemorrhage is inevitable. If the procedure is prolonged, the pull of the sutures on the lids may cause the patient considerable
KEIZER JP. Notched Retractor and Speculum Blades for Ocular Surgery uraer aeru. AMA Arch Ophthalmol. 1955;53(3):411–412. doi:10.1001/archopht.1955.00930010413016
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