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Penetrating Keratoplasty in Interstitial Keratitis
958
AMERICAN JOURNAL OF OPHTHALMOLOGY
13. Deutschmann, R. : Altes und Neues über die Netzhautablosung. Arch. f. Ophth. 117:146, 1926. 14. Schepens, C. L. : Un nouvel ophthalmoscope binoculaire pour l'examen du décollement de la rétine (Projection d'un film sonore). Bull. Soc. Belge Ophtal. 82:9, 1945, and Bull. Soc. Franc. Ophtal. 59:360, 1946. 15. Schepens, C. L. : A new ophthalmoscope dem onstration. Tr. Am. Acad. Ophth. Otolaryng. 51:298, 1947. 16. Schepens, C. L. : Examination of the ora ser rata region: Its clinical significance. Acta XVI Cong. Ophth. (Britannia) 2:1384, 1950. 17. Schepens, C. L. : Progress in detachment sur gery. Tr. Am. Acad. Ophth. Otolaryng. 55:607, 1951. 18. Schepens, C. L. : Ophthalmoscopic observa tions related to the vitreous body. In Importance of the Vitreous Body in Retina Surgery with Special Emphasis on Reoperations. St. Louis, Mosby, 1960, p. 112. 19. Girard-Teulon : Ophthalmoscopie binoculaire où s'exercant par le concours des deux yeux associés. Ann. Oculist. 45 :233, 1861. PENETRATING KERATOPLASTY I N INTERSTITIAL KERATITIS
Editor, American Journal of Ophthalmology: The excellent article by Drs. Rabb and Fine (Am. J. Ophth. 67:907, 1969) evoked nostalgic memories. I concluded 50 years ago, when I was a resident at Elschnig's Eye Clinic in Prague, that corneal trans plantation in eyes scarred from interstitital keratitis is more successful than it is in most other conditions (Arch. f. Ophth. 99: 4, 340, 1919). The implant shown in that article was photographed six years after the operation (fig. 4, p. 345). It was still clear three years later (Arch. f. Ophth. 107:4, 439, 1922). Figure 5 on page 457 shows another implant in an eye with a scar re sulting from interstitital keratitis, which was clear one and one-half years after sur gery. The implants used then in our clinic were much smaller than present-day implants and sutures were rarely used, but the results were, nonetheless encouraging as pioneer work. Karl W. Ascher Cincinnati, Ohio
NOVEMBER, 1969
CORRECTION
The following acknowledgments were omitted from the paper, "Developing objec tives in ophthalmologic education" (Am. J. Ophth. 68:439, 1969), by Bruce E. Spivey, M.D.: This paper was completed during a fellowship year at the Center for the Study of Medical Education, University of Illinois, and supported in part by U S P H S Training Grant 43-67-45.
BOOK REVIEWS T H E PATHOGENESIS OF CONGENITAL GLAU
COMA. By J. G. F . Worst, M.D. Cloth-
bound, 170 pages, 75 figures (74 in black and white, one in color). Assen, Nether lands, Royal Vangorcum, 1966. Dr. Worst's theory is that abnormal angle structures are responsible for congenital glaucoma and that contact lens goniotomy is the treatment of choice. His theory is, in es sence, the mesodermal remnant theory. Rem nants of fetal mesoderm occupy the angle re cess and there is, in addition, an obstruction on the surface of the abnormal angle struc ture, composed of a Descemet's-like mem brane. To remove this obstruction, goni otomy under direct vision is necessary. He describes the different types of goniotomy lenses, spending some time on the particular lens system which he prefers for best visual ization. His special lens uses a flexible can nula with a low vacuum to keep the lens in place. The procedure for viewing the angle with this system is described in detail. The book continues with the description of gonioscopy and angle structures in the de veloping eye, including premature eyes, up to children the age of five years and indi cates that the chamber angle continues to de velop long after birth. It is only at about the second year that the chamber angle resem bles that of the mature eye and the final deepening of the angle is only present at
AMERICAN JOURNAL OF OPHTHALMOLOGY
13. Deutschmann, R. : Altes und Neues über die Netzhautablosung. Arch. f. Ophth. 117:146, 1926. 14. Schepens, C. L. : Un nouvel ophthalmoscope binoculaire pour l'examen du décollement de la rétine (Projection d'un film sonore). Bull. Soc. Belge Ophtal. 82:9, 1945, and Bull. Soc. Franc. Ophtal. 59:360, 1946. 15. Schepens, C. L. : A new ophthalmoscope dem onstration. Tr. Am. Acad. Ophth. Otolaryng. 51:298, 1947. 16. Schepens, C. L. : Examination of the ora ser rata region: Its clinical significance. Acta XVI Cong. Ophth. (Britannia) 2:1384, 1950. 17. Schepens, C. L. : Progress in detachment sur gery. Tr. Am. Acad. Ophth. Otolaryng. 55:607, 1951. 18. Schepens, C. L. : Ophthalmoscopic observa tions related to the vitreous body. In Importance of the Vitreous Body in Retina Surgery with Special Emphasis on Reoperations. St. Louis, Mosby, 1960, p. 112. 19. Girard-Teulon : Ophthalmoscopie binoculaire où s'exercant par le concours des deux yeux associés. Ann. Oculist. 45 :233, 1861. PENETRATING KERATOPLASTY I N INTERSTITIAL KERATITIS
Editor, American Journal of Ophthalmology: The excellent article by Drs. Rabb and Fine (Am. J. Ophth. 67:907, 1969) evoked nostalgic memories. I concluded 50 years ago, when I was a resident at Elschnig's Eye Clinic in Prague, that corneal trans plantation in eyes scarred from interstitital keratitis is more successful than it is in most other conditions (Arch. f. Ophth. 99: 4, 340, 1919). The implant shown in that article was photographed six years after the operation (fig. 4, p. 345). It was still clear three years later (Arch. f. Ophth. 107:4, 439, 1922). Figure 5 on page 457 shows another implant in an eye with a scar re sulting from interstitital keratitis, which was clear one and one-half years after sur gery. The implants used then in our clinic were much smaller than present-day implants and sutures were rarely used, but the results were, nonetheless encouraging as pioneer work. Karl W. Ascher Cincinnati, Ohio
NOVEMBER, 1969
CORRECTION
The following acknowledgments were omitted from the paper, "Developing objec tives in ophthalmologic education" (Am. J. Ophth. 68:439, 1969), by Bruce E. Spivey, M.D.: This paper was completed during a fellowship year at the Center for the Study of Medical Education, University of Illinois, and supported in part by U S P H S Training Grant 43-67-45.
BOOK REVIEWS T H E PATHOGENESIS OF CONGENITAL GLAU
COMA. By J. G. F . Worst, M.D. Cloth-
bound, 170 pages, 75 figures (74 in black and white, one in color). Assen, Nether lands, Royal Vangorcum, 1966. Dr. Worst's theory is that abnormal angle structures are responsible for congenital glaucoma and that contact lens goniotomy is the treatment of choice. His theory is, in es sence, the mesodermal remnant theory. Rem nants of fetal mesoderm occupy the angle re cess and there is, in addition, an obstruction on the surface of the abnormal angle struc ture, composed of a Descemet's-like mem brane. To remove this obstruction, goni otomy under direct vision is necessary. He describes the different types of goniotomy lenses, spending some time on the particular lens system which he prefers for best visual ization. His special lens uses a flexible can nula with a low vacuum to keep the lens in place. The procedure for viewing the angle with this system is described in detail. The book continues with the description of gonioscopy and angle structures in the de veloping eye, including premature eyes, up to children the age of five years and indi cates that the chamber angle continues to de velop long after birth. It is only at about the second year that the chamber angle resem bles that of the mature eye and the final deepening of the angle is only present at