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Repair and Reconstruction in the Orbital Region
VOL. 90, NO. 4
BOOK REVIEWS
op keratoconus than those using soft contact lenses. Thus the two groups are not comparable. Dr. Sommer emphasizes the value of prospective studies with adequate randomization. Thus, in one sampling scheme patients admitted on Monday, Wednesday, and Friday received one form of therapy; those admitted on Tuesday, Thursday, and Saturday received another. Referring physicians quickly learned which therapy was given on which days and arranged for their patients to arrive the day the therapy the physician preferred was being given. With Dr. Sommer's book in hand one can certainly interpret medical reading with far greater sensitivity. It is highly recommended for all who see patients and read about them in medical journals. FRANK W. NEWELL Ocular Pathology. By C. H. Greer. Oxford, Blackwell Scientific Publications, 1979. Hardcover, 281 pages, preface, index, 90 black and white figures. $35.75 This textbook is felicitously written and admirably succeeds in its objective of encompassing the basics of ophthalmic pathology within a manageable length. Up-to-date concepts of inflammation, the role of the neural crest, and the latest World Health Organization classification of eye tumors provide a firm gridwork for an authoritative discussion of these topics. The book is designed for those preparing for examinations, residents in training, and fully trained ophthalmologists who may want to review the subject of opthalmic pathology. It would be particularly useful for residents who are doing a rotation in ophthalmic pathology, because its length allows reading and rereading over a four- to six-week period. While there are large treatises on ophthalmic pathology for those who want
583
in-depth treatments of selected topics, the present book fills the void for the casual reader who wants an overview of the field. I heartily recommend this book to those who would like to whet their appetites on ophthalmic pathology. FREDERICK A. JAKOBIEC Repair and Reconstruction in the Orbital Region, 2nd ed. By John Clark Mustarde. New York, Churchill Livingstone, 1979. Hardcover, 400 pages, index, over 200 black and white figures. $85 This is the second edition of a book first published in 1966. It follows the same format as the first edition with the addition of chapters on hypertelorism and coloboma. The first five chapters deal with reconstruction of partial-thickness defects of the eyelids and conjunctiva. The next six chapters deal with full-thickness eyelid loss and surgery at the medial and lateral canthus. The basic principles of skin surgery are presented in a clear and understandable manner, especially those relating to grafts and flaps. Each case is well illustrated so that the reader can understand why the author chose a particular method, how to perform the surgery, and the final result. Photographs and illustrations are used in combination to clarify the techniques. The author emphasizes his own techniques for the repair of small defects all the way up to reconstruction after loss of both eyelids. Unfortunately, the chapter on lacrimal disease has not been updated to include the newer techniques of canicular reconstruction such as the Quickert-Dryden method of silicone intubation. The chapter on socket reconstruction emphasizes older techniques requiring external pressure on the socket and does not include the technique of fixation to the orbital rim such as presented by Callahan. Although most surgeons no longer recommend the Morel-Fatio spring for paralytic
584
AMERICAN JOURNAL OF OPHTHALMOLOGY
ectropion, the chapter on ectropion describes it without mentioning that erosion into the eyeball is possible. The author's interesting techniques of split-level eyelid resection and levator palpebrae superioris muscle hitch are well presented in the chapter on blepharoptosis. Methods of repairing congenital epicanthus, telecanthus, and blepharophimosis are presented in a clear and understandable manner. He also describes the newer methods of repairing hypertelorism by repositioning the orbital-nasal skeleton. In the chapter on coloboma, severe orbital anomalies associated with coloboma of the eyelid are discussed. The last chapter is an excellent summary of the fine points of tissue transfer using skin grafts, mucous membrane and cartilage grafts, and forehead flaps. Any surgeon dealing with eyelid tumors by frozen-section techniques must be prepared to reconstruct a defect larger than the external appearance of the tumor would indicate. The author gives a step-by-step discussion of the surgery by which one can reconstruct a defect of any size in the orbital region. Although this book describes the techniques used by Dr. Mustards, there are other appropriate procedures which can be used for eyelid reconstruction. Even if one prefers other techniques, an understanding of this book would be useful because these techniques can be combined with other procedures. FREDERICK MAUSOLF
Intervention Combinee Glaucome Cataracte. By A.-G. Ourgaud and P. Gastaud. Marseille, Diffusion Cenerale de Librairie, 1980. Paperbound, 151 pages, 44 black and white figures. $34.45 The introductory section of this monograph contains an excellent description of
OCTOBER, 1980
the macroscopic and microscopic appearance of the chamber angle. Next, the authors review the problem of the combined presence of cataracts and glaucoma. They make the obvious statement that if the glaucoma is mild and the cataract severe, the latter should be removed; if the situation is reversed, then the glaucoma should be treated. However, the bulk of their publication deals with those cases that require both a filtering operation and cataract extraction and they recommend that this be treated by a combined trabeculectomy and cataract extraction. They recognize that there are various techniques for performing this but give their own in great detail. Essentially it consists of a scleral flap under a large conjunctival flap, a trabeculectomy done with scissors, and then extension of the wound nasally and temporally to allow for extraction of the cataract. The wound is then closed with interrupted 7-0 or 8-0 Vicryl sutures and the conjunctiva with either a running suture or interrupted sutures. The final section lists their results and complications. Perhaps the most valuable portion of this monograph is the complete bibliography on surgical intervention in the presence of glaucoma and cataracts. DAVID SHOCH
Pediatric Ophthalmology Practice. By Eugene M. Helveston and Forrest D. Ellis. St. Louis, C. V. Mosby Co., 1979. Hardcover, 303 pages, index, bibliography, 422 black and white figures. $43.50. This book gives a practical account of the more common topics encountered in pediatric ophthalmology, in a concise, easy-to-read, atlas-like style. The authors, who are associates, do not intend to provide an exhaustive exposition on
BOOK REVIEWS
op keratoconus than those using soft contact lenses. Thus the two groups are not comparable. Dr. Sommer emphasizes the value of prospective studies with adequate randomization. Thus, in one sampling scheme patients admitted on Monday, Wednesday, and Friday received one form of therapy; those admitted on Tuesday, Thursday, and Saturday received another. Referring physicians quickly learned which therapy was given on which days and arranged for their patients to arrive the day the therapy the physician preferred was being given. With Dr. Sommer's book in hand one can certainly interpret medical reading with far greater sensitivity. It is highly recommended for all who see patients and read about them in medical journals. FRANK W. NEWELL Ocular Pathology. By C. H. Greer. Oxford, Blackwell Scientific Publications, 1979. Hardcover, 281 pages, preface, index, 90 black and white figures. $35.75 This textbook is felicitously written and admirably succeeds in its objective of encompassing the basics of ophthalmic pathology within a manageable length. Up-to-date concepts of inflammation, the role of the neural crest, and the latest World Health Organization classification of eye tumors provide a firm gridwork for an authoritative discussion of these topics. The book is designed for those preparing for examinations, residents in training, and fully trained ophthalmologists who may want to review the subject of opthalmic pathology. It would be particularly useful for residents who are doing a rotation in ophthalmic pathology, because its length allows reading and rereading over a four- to six-week period. While there are large treatises on ophthalmic pathology for those who want
583
in-depth treatments of selected topics, the present book fills the void for the casual reader who wants an overview of the field. I heartily recommend this book to those who would like to whet their appetites on ophthalmic pathology. FREDERICK A. JAKOBIEC Repair and Reconstruction in the Orbital Region, 2nd ed. By John Clark Mustarde. New York, Churchill Livingstone, 1979. Hardcover, 400 pages, index, over 200 black and white figures. $85 This is the second edition of a book first published in 1966. It follows the same format as the first edition with the addition of chapters on hypertelorism and coloboma. The first five chapters deal with reconstruction of partial-thickness defects of the eyelids and conjunctiva. The next six chapters deal with full-thickness eyelid loss and surgery at the medial and lateral canthus. The basic principles of skin surgery are presented in a clear and understandable manner, especially those relating to grafts and flaps. Each case is well illustrated so that the reader can understand why the author chose a particular method, how to perform the surgery, and the final result. Photographs and illustrations are used in combination to clarify the techniques. The author emphasizes his own techniques for the repair of small defects all the way up to reconstruction after loss of both eyelids. Unfortunately, the chapter on lacrimal disease has not been updated to include the newer techniques of canicular reconstruction such as the Quickert-Dryden method of silicone intubation. The chapter on socket reconstruction emphasizes older techniques requiring external pressure on the socket and does not include the technique of fixation to the orbital rim such as presented by Callahan. Although most surgeons no longer recommend the Morel-Fatio spring for paralytic
584
AMERICAN JOURNAL OF OPHTHALMOLOGY
ectropion, the chapter on ectropion describes it without mentioning that erosion into the eyeball is possible. The author's interesting techniques of split-level eyelid resection and levator palpebrae superioris muscle hitch are well presented in the chapter on blepharoptosis. Methods of repairing congenital epicanthus, telecanthus, and blepharophimosis are presented in a clear and understandable manner. He also describes the newer methods of repairing hypertelorism by repositioning the orbital-nasal skeleton. In the chapter on coloboma, severe orbital anomalies associated with coloboma of the eyelid are discussed. The last chapter is an excellent summary of the fine points of tissue transfer using skin grafts, mucous membrane and cartilage grafts, and forehead flaps. Any surgeon dealing with eyelid tumors by frozen-section techniques must be prepared to reconstruct a defect larger than the external appearance of the tumor would indicate. The author gives a step-by-step discussion of the surgery by which one can reconstruct a defect of any size in the orbital region. Although this book describes the techniques used by Dr. Mustards, there are other appropriate procedures which can be used for eyelid reconstruction. Even if one prefers other techniques, an understanding of this book would be useful because these techniques can be combined with other procedures. FREDERICK MAUSOLF
Intervention Combinee Glaucome Cataracte. By A.-G. Ourgaud and P. Gastaud. Marseille, Diffusion Cenerale de Librairie, 1980. Paperbound, 151 pages, 44 black and white figures. $34.45 The introductory section of this monograph contains an excellent description of
OCTOBER, 1980
the macroscopic and microscopic appearance of the chamber angle. Next, the authors review the problem of the combined presence of cataracts and glaucoma. They make the obvious statement that if the glaucoma is mild and the cataract severe, the latter should be removed; if the situation is reversed, then the glaucoma should be treated. However, the bulk of their publication deals with those cases that require both a filtering operation and cataract extraction and they recommend that this be treated by a combined trabeculectomy and cataract extraction. They recognize that there are various techniques for performing this but give their own in great detail. Essentially it consists of a scleral flap under a large conjunctival flap, a trabeculectomy done with scissors, and then extension of the wound nasally and temporally to allow for extraction of the cataract. The wound is then closed with interrupted 7-0 or 8-0 Vicryl sutures and the conjunctiva with either a running suture or interrupted sutures. The final section lists their results and complications. Perhaps the most valuable portion of this monograph is the complete bibliography on surgical intervention in the presence of glaucoma and cataracts. DAVID SHOCH
Pediatric Ophthalmology Practice. By Eugene M. Helveston and Forrest D. Ellis. St. Louis, C. V. Mosby Co., 1979. Hardcover, 303 pages, index, bibliography, 422 black and white figures. $43.50. This book gives a practical account of the more common topics encountered in pediatric ophthalmology, in a concise, easy-to-read, atlas-like style. The authors, who are associates, do not intend to provide an exhaustive exposition on