The three new methods of ocular tendon transplantation make the new attachments external, in varying amounts, to the median vertical plane of the globe, with the idea of increasing the mechanical chances of securing outward rotation and of lessening tension on the portion transplanted. The illustrations show this mechanical aspect in a diagrammatic way.
The vertical recti will be used for ease of description, although the operations can be applied for isolated paralysis or paresis of any rectus muscle.
First Method.—This method consists in a transplantation of the inner three fourths of the tendons of the vertical recti under the uncut outer fourth to the corresponding margins of the externus insertion. This operation was performed on both eyes of a patient of Dr. Hans and Dr. Otto Barkan at their request. The condition was double, complete, congenital abducens palsy in a girl 19 years of age.