Fig. 14. A. The two layers of intermuscular septum on the toe of the Stevens hook are opened anterior to the tendon with blunt Westcott scissors. B. A second Stevens hook is passed through the anterior opening of the intermuscular septum and beneath the tendon from anterior to posterior. The tenotomy is performed between them with blunt Westcott scissors. Care is taken to avoid damaging the adjacent intermuscular septum. C. The cut ends of the tendon are visualized as they lie separated within the small rent in the intermuscular septum nasal to the superior rectus muscle. (Del Monte MA, Archer SM: Atlas of Pediatric Ophthalmology and Strabismus Surgery. New York: Churchill Livingstone, 1993) |