Fig. 10. Exposure and limbus-based conjunctival flap preparation. When preparing a limbus-based conjunctival flap, place an 8-0 Vicryl corneal traction suture 1 mm from the limbus at the 12-o'clock position at two thirds corneal thickness. Infraduct the globe, and insufflate the conjunctiva with balanced salt solution through a 30-gauge needle 10 mm. from the limbus. This allows easier dissection of the conjunctiva from the episclera. Insert sharp Wescott scissors into the conjunctival needle tract, and extend the conjunctival incision. The flap is dissected down to the limbus in a buttonhole-free manner with blunt Wescott scissors. Some surgeons prefer a superior rectus bridle suture; the technique used to rotate the globe is dependent on physician training, comfort level and type of flap.