File:Atlas and epitome of operative ophthalmology (1905) (14595930340).jpg

Identifier: atlasepitomeofop00haab (find matches)
Title: Atlas and epitome of operative ophthalmology
Year: 1905 (1900s)
Authors: Haab, O. (Otto), b. 1850 De Schweinitz, G. E. (George Edmund), 1858-1938
Subjects: Ophthalmologic Surgical Procedures
Publisher: Philadelphia, New York (etc.) : W.B. Saunders and company
Contributing Library: University of California Libraries
Digitizing Sponsor: Internet Archive

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, hasbeen controlled, three sutures with two needles each areintroduced from without inward through the upper por-tion of the dissected skin of the lid, so that when thesutures are drawn tight they form a fold in the skin,resembling as nearly as possible a corresponding fold inthe normal eye. The sutures are carried upward under-neath the skin, somewhat as shown in Plate 13, Fig. 1,and the needles are brought out above the incision ; thatis, at about the same point as in Pagenstechers operation.There they are tied, and then allowed to remain in placefor from a week to ten days. If necessary, they may betightened from time to time. The wound in the eyebrowis closed with a continuous suture. The important feat-ure of the operation is the formation of an extensivewound surface, the cicatrization of which permanentlyfixes the artificial fold in the upper lid. Another featureis that the sutures are carried upward, bringing the upperdome of the fold, which also belongs to the wound sur- 119
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300 OPERATIONS ON THE EYE. Plate 13. Fig. 1.—Pagenstechers ptosis operation in a young girl with congeni-tal ptosis. Fig. 2.—Gaillards suture in an old man with spastic entropion. face, into intimate union with the lower extremities of themuscle bundles of the frontal muscle, and thus enablingthe latter to transfer much of its action to the lid. 5. In Panas operation the lid is fastened to thefrontal muscle by forming a skin flap about 8 mm. wideand 5 to 6 mm. high in the lid, undermining it carefullyand directing it upward. This flap is then drawn upunder the skin covering the region of the eyebrows. Forthis purpose a horizontal incision 3 mm. long is madeimmediately above the eyebrow and parallel with it;through this incision the skin between the eyebrow andeyelid is undermined, so that the lid flap can be drawnunder this bridge of skin with sutures and fastened inplace. The operation is very effective, but leaves unsightlyscars in the upper portion of the lid. 6. Motais* Operat

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