A modified enucleation procedure places the implantwithinthe muscle coneposteriorto the posterior layer of Tenon's capsule. Another important surgical maneuver is the suturing of the inferior oblique muscle to the inferior border of the lateral rectus muscle, which helps to maintain the integrity of Lockwood's ligament and provide additional support for the implant. A hollow silicone implant was devised and used in conjunction with the procedure. The results have been very encouraging with less formation of a superior lid sulcus and upper lid ptosis.
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David B. Soll (1972) studied this question.