Atlas and epitome of operative ophthalmology . f the lid. 6. Motais* Operation.—Instead of the frontal mus-cle, the rectus superior may also be utilized to assist inthe elevation of the upper lid. This very useful andoriginal operation of Motais is particularly adapted tocases of ptosis (especially bilateral cases), in which thelevator muscle is entirely wanting. To secure goodaccess to the operative field, the eye is first rotated down-ward with the single or double hooks, and the upper lid,after being everted, is drawn upward (Fig. 125). Liga-tures may be used instead of hooks. A horizontal
Atlas and epitome of operative ophthalmology . f the lid. 6. Motais* Operation.—Instead of the frontal mus-cle, the rectus superior may also be utilized to assist inthe elevation of the upper lid. This very useful andoriginal operation of Motais is particularly adapted tocases of ptosis (especially bilateral cases), in which thelevator muscle is entirely wanting. To secure goodaccess to the operative field, the eye is first rotated down-ward with the single or double hooks, and the upper lid,after being everted, is drawn upward (Fig. 125). Liga-tures may be used instead of hooks. A horizontal inci-sion is then made in the bulbar conjunctiva and in Tenonscapsule, and the tendon of the superior rectus searchedfor. A tongue is then excised from the middle of thetendon, running as far as the insertion. A suture withtwo needles is passed through this tongue (Fig. 126),which is then, by means of this suture, inserted betweenthe tarsus and the skin of the upper lid. For that pur-pose an opening is made with the scissors in the conjunc-. er* *x8jhj
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