. Surgery, its principles and practice . enuded surface of the eyeball and of the inner side of the gaps are closed by sutures, d and e. The con- are as valuable as the systematic breaking up of adhesions several times aday with a probe, associated with rigorous local antisepsis. Operations for Symblepharon.—If in spite of these precautions asymblepharon forms, after all inflammatory symptoms have subsided^an attempt must be made to remedy the condition. Unfortunately, theresults are often most unsatisfactory. In general terms, the adhesionsshould be divided, and the raw surfaces
. Surgery, its principles and practice . enuded surface of the eyeball and of the inner side of the gaps are closed by sutures, d and e. The con- are as valuable as the systematic breaking up of adhesions several times aday with a probe, associated with rigorous local antisepsis. Operations for Symblepharon.—If in spite of these precautions asymblepharon forms, after all inflammatory symptoms have subsided^an attempt must be made to remedy the condition. Unfortunately, theresults are often most unsatisfactory. In general terms, the adhesionsshould be divided, and the raw surfaces left after they are severed coveredwith flaps of healthy conjunctiva taken from the unaffected parts of theeyeball. This is Teales method (Fig. 465). Occasionally the symble-pharon can be dissected back to the retrotarsal fold and doubled uponitself, so as to oppose a mucous surface to the globe. It is fixed in posi-tion by means of a ligature armed at either end with a needle passed OPERATIONS ON SCLERA, CORNEA, AND CONJUNCTIVA. 889. through the hd from the conjunctival surface. In more extensive symble-pharons an attempt may be made, after the eyelid has been dissected fromthe eyeball, to prevent readhesion by inserting a graft made of rabbitsconjunctiva, or, as Hotz suggests, a Thiersch graft. As the movementof the lid is apt to displace it the transplanted skin, following the adviceof Hotz and May, may be secured by means of a rigid support, for example,a thin piece of lead, or a suitable glass prosthesis. This plate may bemade of melted lead and covered with paraffin, as recently recommendedby Wilder. Operations for Pterygium.—To remove a pterygium, which is atriangular shaped growth composed of vascular hypertrophied conjunc-tival and subconjunctival tis-sue, in its true form usually psituated at the inner side of j-the eye with its apex attachedto the corneal border, a va-riety of operations have beenpractised, which in generalterms include excision, stran-gulation
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