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Atlas of strabismus surgery
202
Surv Ophtholmol
23 (3) November-December
1978
abroad. The articles are pithy and lucidly written. The book contains abundant illustrations, drawings, and photographs which are of excellent quality; the legends are clear and concise and the documentation is impressive. Accompanying the majority of the chapters are brief summations and roundtable discussions which allow for the clarification of material presented in the preceding papers. At the end of each paper is a good, up-to-date (though abbreviated) bibliography that serves as a starting point for those who wish to read further. The first chapter deals with the automation of perimetry. Professor Fankhauser emphasizes to the clinician that the era of computers, artificial intellect, and automation has arrived in perimetry. The Octopus and Tubingen automatic perimeters, which are not widely known or used in this country, may hold promise for the future. There are chapters dealing with the visual field in glaucoma, neuroophthalmology, and diseases of the fundus and optic disc; toxic amblyopia should be of special interest to the clinical ophthalmologist. However, the remaining chapters which include articles on visual field methodology, perimetry in squints, color perimetry, and objective perimetry, including electro-perimetry, are primarily intended for the basic scientist or the clinical investigator. This symposium puts forward a wide variety of excellent papers and provides all investigators in the area of perimetry, whether clinicians or basic scientists, with a valuable compendium. Any area would be of interest to someone in that same or parallel discipline, but the technical nature of many of the articles might, unfortunately, allow this book to go unread by the great majority of ophthalmic clinicians. Finally, the editor, E. L. Greve, is to be congratulated for the excellent reproductions and the remarkably few errors. SHELDON
RABIN
Atlas of Strabismus Surgery, by Eugene M. Helveston. St. Louis, C. V. Mosby, 1977, 262 pp., 382 illus. Price: $35.50 This is an updated version of Helveston’s wellreceived earlier volume of the same title. As he states in the preface, developments in this field have been numerous in the intervening four years, and his response in this present edition is admirable. The anatomic features important to strabismus surgery are discussed in detail and are well illustrated. The importance of Tenon’s capsule and the various orbital fat compartments are properly stressed. Some confusion is possible, however, in the discussion of “anterior” and “posterior” Tenon’s capsule; to some extent these terms are used to indicate a superficial and a deeper fascial layer, respectively. The anatomic features of the anterior ciliary circulation and vortex veins are
BOOK REVIEWS
thoroughly discussed, as groundwork for the concern for these structures in surgical planning and performance which is evident throughout the book. Following descriptions of Helveston’s preferences in anesthesia, pre- and postoperative care, sutures, needles, etc, the remainder of the book is devoted to step-by-step depiction of essentially all ocular muscle operations currently in use, including the newer (or rediscovered) techniques of posterior fixation and adjustable sutures. Although most alternative procedures to achieve a given result are mentioned, the author has taken the permissible liberty of emphasizing his own choices. Sufficient textual and illustrative detail is supplied to enable the reader to perform the necessary operative maneuvers. The book concludes with an excellent discussion of complications and their management, and presents several sample cases well chosen to illustrate and reinforce Helveston’s concepts. There are only a few exceptions I would take that do not reflect merely different preferences. One such is the statement that a superior cul-desac incision should always be sutured. I do not do this and have never experienced the complication of Tenon’s capsule prolapse from this cause. In enumerating unusual causes of Brown’s syndrome, the author does not mention the functional shortening of the superior oblique tendon by congenital attachments between it and the superior rectus coverings or upper nasal quadrant of the globe, In describing superior oblique tendon transfer, the text does not convey the true degree of difficulty of fracturing the trochlea by what is essentially a blink maneuver. In Case Report 3, it is not stated whether displacement of the incisions of the operated horizontal rectus muscles was considered for a V-pattern difference of 40 prism diopters, as would have been consistent with Helveston’s discussion of the results to be expected from various surgical approaches to this problem. A Jensen procedure for Duane’s syndrome is somewhat controversial, and some indication of the author’s views on simultaneous weakening of co-contracting medial and lateral rectus muscles in this entity, and on the controversy of whether and when to operate for orbital floor fractures, would have been welcome. The authority for several statements throughout the book, including the valuable list of “Surgical Aphorisms,” is not always clear. This is due at least in part to the listing of references in a general bibliography rather than as specific citations. Lastly, I have always preferred “traction test” to “forced duction,” feeling that force has no place in this diagnostic procedure. The style and layout are quite pleasing and the book is handsomely bound. It is an extremely worthwhile addition to the personal collections of ophthalmologists of all levels of experience and to the libraries of all ophthalmology training centers. EDWARD L. RAAB
Surv Ophtholmol
23 (3) November-December
1978
abroad. The articles are pithy and lucidly written. The book contains abundant illustrations, drawings, and photographs which are of excellent quality; the legends are clear and concise and the documentation is impressive. Accompanying the majority of the chapters are brief summations and roundtable discussions which allow for the clarification of material presented in the preceding papers. At the end of each paper is a good, up-to-date (though abbreviated) bibliography that serves as a starting point for those who wish to read further. The first chapter deals with the automation of perimetry. Professor Fankhauser emphasizes to the clinician that the era of computers, artificial intellect, and automation has arrived in perimetry. The Octopus and Tubingen automatic perimeters, which are not widely known or used in this country, may hold promise for the future. There are chapters dealing with the visual field in glaucoma, neuroophthalmology, and diseases of the fundus and optic disc; toxic amblyopia should be of special interest to the clinical ophthalmologist. However, the remaining chapters which include articles on visual field methodology, perimetry in squints, color perimetry, and objective perimetry, including electro-perimetry, are primarily intended for the basic scientist or the clinical investigator. This symposium puts forward a wide variety of excellent papers and provides all investigators in the area of perimetry, whether clinicians or basic scientists, with a valuable compendium. Any area would be of interest to someone in that same or parallel discipline, but the technical nature of many of the articles might, unfortunately, allow this book to go unread by the great majority of ophthalmic clinicians. Finally, the editor, E. L. Greve, is to be congratulated for the excellent reproductions and the remarkably few errors. SHELDON
RABIN
Atlas of Strabismus Surgery, by Eugene M. Helveston. St. Louis, C. V. Mosby, 1977, 262 pp., 382 illus. Price: $35.50 This is an updated version of Helveston’s wellreceived earlier volume of the same title. As he states in the preface, developments in this field have been numerous in the intervening four years, and his response in this present edition is admirable. The anatomic features important to strabismus surgery are discussed in detail and are well illustrated. The importance of Tenon’s capsule and the various orbital fat compartments are properly stressed. Some confusion is possible, however, in the discussion of “anterior” and “posterior” Tenon’s capsule; to some extent these terms are used to indicate a superficial and a deeper fascial layer, respectively. The anatomic features of the anterior ciliary circulation and vortex veins are
BOOK REVIEWS
thoroughly discussed, as groundwork for the concern for these structures in surgical planning and performance which is evident throughout the book. Following descriptions of Helveston’s preferences in anesthesia, pre- and postoperative care, sutures, needles, etc, the remainder of the book is devoted to step-by-step depiction of essentially all ocular muscle operations currently in use, including the newer (or rediscovered) techniques of posterior fixation and adjustable sutures. Although most alternative procedures to achieve a given result are mentioned, the author has taken the permissible liberty of emphasizing his own choices. Sufficient textual and illustrative detail is supplied to enable the reader to perform the necessary operative maneuvers. The book concludes with an excellent discussion of complications and their management, and presents several sample cases well chosen to illustrate and reinforce Helveston’s concepts. There are only a few exceptions I would take that do not reflect merely different preferences. One such is the statement that a superior cul-desac incision should always be sutured. I do not do this and have never experienced the complication of Tenon’s capsule prolapse from this cause. In enumerating unusual causes of Brown’s syndrome, the author does not mention the functional shortening of the superior oblique tendon by congenital attachments between it and the superior rectus coverings or upper nasal quadrant of the globe, In describing superior oblique tendon transfer, the text does not convey the true degree of difficulty of fracturing the trochlea by what is essentially a blink maneuver. In Case Report 3, it is not stated whether displacement of the incisions of the operated horizontal rectus muscles was considered for a V-pattern difference of 40 prism diopters, as would have been consistent with Helveston’s discussion of the results to be expected from various surgical approaches to this problem. A Jensen procedure for Duane’s syndrome is somewhat controversial, and some indication of the author’s views on simultaneous weakening of co-contracting medial and lateral rectus muscles in this entity, and on the controversy of whether and when to operate for orbital floor fractures, would have been welcome. The authority for several statements throughout the book, including the valuable list of “Surgical Aphorisms,” is not always clear. This is due at least in part to the listing of references in a general bibliography rather than as specific citations. Lastly, I have always preferred “traction test” to “forced duction,” feeling that force has no place in this diagnostic procedure. The style and layout are quite pleasing and the book is handsomely bound. It is an extremely worthwhile addition to the personal collections of ophthalmologists of all levels of experience and to the libraries of all ophthalmology training centers. EDWARD L. RAAB