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September 1969

Modification of the Limbal Approach to Surgery of the Rectus Muscles

Author Affiliations

From the Wilmer Ophthalmological Institute, the Johns Hopkins Hospital and University, Baltimore.

Arch Ophthalmol. 1969;82(3):349-350. doi:10.1001/archopht.1969.00990020351010

THE ADVANTAGES of the limbal approach in strabismus surgery were described in a recent publication.1 I have continued to employ this method with satisfactory cosmetic and functional results. Only minor complications have occasionally been encountered such as bleeding from the limbal capillaries, an uneven conjunctival margin near the limbus, and difficulty in identifying Tenon's space when beginning the incision at the limbus.

Three instances of a potentially more serious complication have come to my attention, in which the surgeon had entered the sclera with sharply pointed scissors in an attempt to explore Tenon's space. All of these complications can be avoided by a simple modification of the limbal incision that was recently suggested to me by G. Mackensen, MD, (oral communication, 1968) and that I have employed with complete satisfaction for the past six months. Because an increasing number of eye surgeons are favoring the limbal approach in strabismus

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