A modification of the operation for strabismus / by Richard Liebreich.
- Richard Liebreich
- Date:
- 1866
Licence: Public Domain Mark
Credit: A modification of the operation for strabismus / by Richard Liebreich. Source: Wellcome Collection.
Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.
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![[From the “ British Medical Journal, December 10th, I860.] A MODIFICATION OF THE OPERATION FOR STRABISMUS. BY RICHARD LIEBREICH, M.D., PROFESSOR OF OPHTHALMOLOGY, PARIS. It is well known that, if the internal rectus muscle tie-' divided in the manner now generally practised, it is possible to correct a squint of from 2 to 21 lines in adults, and from 21 to 8 lines in children. But, if the deviation exceed this extent, it will be necessary to perform two, three, or even more, successive oper- ations. Whilst the division of the effect between two oper- ations, one on each eye, offers certain advantages with regard to the symmetry and uniformity of the movements of the eyes, the performance of a third or fourth operation—i. e., its repetition upon a muscle which has been already divided—is attended by great disadvantages. In fact, by such a repetition of the tenotomy, anything like an approximative calcula- tion of the result is rendered impossible. In some cases the effect will be nil, in others excessive; so that, as was once said by a well known ophthalmic surgeon, when a third tenotomy has once been made, it is impossible to predict how many more it may be necessary to perform upon the same individual. This is probably owing to the cicatricial adhesions which are formed after the first operation, as they prevent the performance of the usual simple ten- otomy. For, if we be not careful to divide these adhesions completely, it may easily occur that a small band, which has escaped our notice, will mar the effect; or if, in order to ensure their complete divi- sion, we have been obliged to incise the parts freely, a divergent squint (in division of the internal rectus) not unfrequently results, with considerable loss of mobility inwards, sinking of the caruncle, etc.; in](https://iiif.wellcomecollection.org/image/b22450270_0003.jp2/full/800%2C/0/default.jpg)
