The Swan incision: an underutilized conjunctival approach to strabismus surgery

Background: The Swan incision is an easy-to-learn yet underutilized approach to strabismus surgery. We compare the Swan approach to the limbal and the fornix approaches and report the results of a survey of surgeons who had previously learned the technique. Methods: We distributed a survey to former fellows of the senior author (NBM) to determine which approaches to strabismus surgery they have continued to use. For comparison, we also distributed our survey to other strabismus surgeons practicing in the greater New York area. Results: Surgeons in both groups reported using all three approaches. However, while 60% of those trained by NBM reported still utilizing the Swan approach, only 13% of other strabismus surgeons did. Those who utilize the Swan approach report employing it for both primary and secondary cases. Conclusions: Our survey results indicate that surgeons who employ the Swan approach as described here are satisfied with the results. The Swan incision provides an effective surgical approach to the muscles in strabismus surgery.