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ERICK BOTHUN: So I like to mark up the conjunctiva. This is such little thin lacy stuff. So classic limbal approach. Make a relaxing incision. And then as a rule of thumb, we're not going to touch things in this. We'll protect the flap.

So you spread on each side by going outside of the flap. So we hook the medial rectus. So just gently, I kind of do one side of the muscle at a time. I always am a little cautious using a q-tip dissection here. All right, so we're going to recess this muscle with 0 Vicryl.

You can take it all the way off, because we're going to-- it's an open conj, or a limbal approach. Nice small bites. Again, always bringing that back blade forward first, and then the front blade back to it. Great.

So I typically like to attach this muscles back to their insertion, at approximately 5 and 1/2 millimeters. You can get wider, 5 and 1/2, 6. Great.

OK. So now we'll go ahead and do the same procedure, do a limbal opening and a medial rectus recession on the left eye. So now, hook the medial, pull straight towards you, large hook. Now we got it all. A small recession like we're doing, you don't need to trim very much. Yeah. So muscle is exposed, and we will imbricate.

[INAUDIBLE]

So there is a little plaque here, I think. The start of an early plaque. So this pass will have to more come forward. This pass-- we'll see as you go into it, even that might be calcified.

So in this eye, we're setting the muscle to the sclera, and adding a knot that has what's called a noose, an adjustable noose. The knot is tied. Now you could get a take a tires, and cinch that both. Maybe we need to cinch the top one more than the bottom one.

There we go. That's good. That's good. Let's try it a little lower. Nice. Let's just trim this right here. It's just a little bit of a [INAUDIBLE] there.