Fig. 1. A. All four recti muscles are tagged. A superior fornix suture has been inserted. The superior and inferior oblique muscles are allowed to retract. In the event that a nonvascularizing implant, such as a silicone sphere, is used, only the medial and lateral recti muscles are tagged. B. The globe is pulled forward by use of previously placed traction sutures inserted through the insertional stumps of the medial and lateral recti muscles. A clamp is placed on the optic nerve. C. The posterior rent in Tenon's fascia is closed if a nonvascularizing implant is used. |