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October 1971


Arch Ophthalmol. 1971;86(4):483. doi:10.1001/archopht.1971.01000010485022

To the Editor.  —The limbal-conjunctival approach to strabismus surgery has become widely used following its repopularization by von Noorden.1 A commonly used method of identifying the apices of the conjunctival radial cuts has been to use black silk marking sutures. A modification of this is described in which the black silk suture is used to retract the conjunctiva thereby facilitating exposure of the underlying structures and minimizing trauma.A conjunctival peritomy is done with radial incisions above and below the muscle. One double-armed, 4-0 black silk suture is placed through one of the apices of the conjunctival incision and a single knot tied at approximately the center of the suture. The remaining apex is then pierced by either needle of the double armed suture and a second knot tied. A length of suture corresponding to the length of the peritomy is maintained between the two knots. The suture ends