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Kenneth C. Swan, MD

Arch Ophthalmol. 1970;83(2):134-140.

Abstract
Fascial expansions to the lids and orbital wall do not arise directly from the rectus muscles as "check ligaments." Instead, this fascia merges in the fornices with Tenon's capsule and subconjunctiva forming a tissue ring which encircles the globe. Incisions anterior to this fornix ring permit recession and resection under Tenon's capsule without disturbing fascial interrelations. Incisions into the fornices cause adnexal deformities. Tenon's capsule is easily elevated from the muscle sheaths which are separate structures continuous with anterior episcleral and intermuscular membranes. Integrity of the sheaths should be preserved. They are the primary source of fibroblasts for reattachment of tendons to the sclera. Fibroplasia from sheath defects causes adhesions.

Author Affiliations
Portland, Ore

From the John E. Weeks Institute of Ophthalmology, University of Oregon Medical School, Portland, Ore.

Footnotes
Submitted for publication Sept 2, 1969.

Read before the Section on Ophthalmology at the 118th annual convention of the American Medical Association, New York, July 14, 1969.

Reprint requests to 3181 SW Sam Jackson Park Rd, Portland, Ore 97201 (Dr. Swan).

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