Importance of Tenon's capsule in squint surgery

A procedure for dealing with Tenon's capsule in squint surgery on the horizontal muscles, which preserves intact the relations of the various expansions of Tenon's capsule, distorts and damages them as little as possible and replaces Tenon's capsule as an intact layer over the muscle at the end of surgery is outlined. It depends on adequate fixation and the avoidance of damage to and distortion of Tenon's capsule by the use of muscle hooks to 'fish' for the muscle. It is claimed that this method produces less fibrosis around the muscle post-operatively and allows a better final result.