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The Surgical Rehabilitation of Vision
BOOK REVIEWS Edited by Mark J. Mannis, M.D.
The chapters on corneal degenerations and dystrophies are a pleasure to read. Although not comprehensive, they are filled with illustra tive designs and photographs. Primary and systemic immunologie disorders are well cov ered. Chapters are included on endocrine disor ders, disorders of lipid and carbohydrate me tabolism, and other metabolic abnormalities. The survey of primary skin disorders with ocu lar effects is useful as are the sections on drugs and toxic and allergic reaction to topical medi cations. Overall, the goals of the author have been exceptionally well met. Residents and general ophthalmologists will find this a readable, in formative, and friendly text. For those wishing more extensive or source information, for those who specialize in corneal and external disease, for those wishing a review of the basic science literature, or for those interested in the cutting edge information, this is not the appropriate text. I would guess, however, that even these individuals will benefit from this useful book during the course of daily practice.
Grayson's Diseases of the Cornea, ed. 3. By Robert C. Arffa. Philadelphia, Mosby Year Book, 1991. 725 pages, index, illustrated. $169 Reviewed by RONALD D. PLOTNIK
Rochester, New York The preface to the third edition of this classic work describes the goals of the author: reada bility, single authorship, clinical orientation, a high number of quality illustrations, and the use of tables. It further states that the intended readership includes ophthalmology residents and the general ophthalmologist. Dr. Arffa has achieved these objectives remarkably well. Grayson's Diseases of the Cornea provides a review of corneal and external disease that is primarily clinical and practical. The text begins with a review of anatomy and physiology of the cornea, conjunctiva, eyelids, and tear film. Al though not comprehensive, the review contains excellent clinical correlations, numerous pho tographs, and well-drawn diagrams. The chap ter on history and examination is fairly com plete. It describes both simple and more complex examination techniques. Additionally, it includes differential diagnoses for various signs including cornea verticillata, crystalline keratoplasty, vascularization, and punctate keratitis. The chapter on laboratory evaluation is an informative review of cytologie techniques and their interpretation as well as culture, biop sy, and impression cytology techniques. The remaining chapters deal with the broad range of corneal and external disease. Congeni tal anomalies are reviewed in detail with many associated diagrams. Follicular, neonatal, and bacterial conjunctivitis are well covered in a multi-page table that details conjunctival and corneal signs, cytologie findings, etiologic fac tors, and other pertinent information. Noninfectious conjunctivitis is covered less thorough ly but is well organized and readable. Thorough tables relating to bacterial keratitis include such information as likely organisms, broadspectrum initial antibiotic coverage, prepara tion of fortified topical antibiotics, preparation of subconjunctival antibiotics, and approaches to antibiotic choice. The chapter on viral dis eases is clear, directed, and specific. A construct of appropriate treatment for infectious and im mune-related manifestations of herpes simplex is particularly straightforward and useful.
The Surgical Rehabilitation of Vision. Edited by Lee T. Nordan, W. Andrew Maxwell, and James A. Davison. New York, Raven Press, 1992. 375 pages, illustrated. $125 Reviewed by ERICH GROOS
Nashville, Tennessee The tone of this book is set by the editors' preface and the forewords. The goals of the text, stated in the first chapter, "The Phi losophy of Eye Sur gery," are based on the premise that ex cellence in surgical technique is re quired to reap the ultimate reward: the best uncorrected vision for the pa tient. The editors set out to provide under standing of the techniques necessary to 518
Vol. 114, No. 4
perform state-of-the-art anterior segment sur gery, to provide a comprehensive reference text on the subject, and to instill in the reader the goal of achieving excellence. Excellence, they state, is characterized by five key components: universality, essential knowledge, desire, cour age, and benevolence. Let us then examine the work within the framework of these character istic components. Universality implies that excellence may flourish within any area of human endeavor. This applies to refractive surgical skills no less than any other field. Essential knowledge is the foundation upon which excellence is built and is certainly the basis of any good text. The information within this book is well organized, attractively format ted, and well illustrated. The chapters in Sec tion 1, which deals with recent developments, cover a variety of topics ranging from optics to computers to perioperative anesthesia. Section 2, on surgical instrumentation, is particularly well written and contains a vast array of infor mation about instruments, sutures, and needles used in anterior segment surgery. Sections 3 and 4 deal with surgery of the lens. These sections comprise nearly half the book. The chapters on intraocular lenses and capsulorrhexis are replete with spectacular photographs of intraocular lenses, both virgin and in situ. The chapters that follow have a dizzying array of techniques for extraction of the human lens and the approach to associated surgical compli cations, including ametropia. Each chapter con tains an ample number of color plates depicting the steps in the procedures. The discussions are lucid and succinct. The chapters on corneal surgery deal primarily with techniques suited for refractive surgery as well as keratoplasty. The final chapters seem like afterthoughts to fill in the prerequisites for a text on anterior seg ment surgery. The chapter describing ap proaches to ptosis repair is well illustrated and well written but misplaced in a book about anterior segment surgery. Desire to be the best is a component of excellence that should lead the reader to desire the best outcome for the patient, that is, opti mal uncorrected visual acuity. Being the best by striving for excellence brings us to courage; meaning the courage to apply the best solutions despite the previous failures. Unfortunately, the authors do not dis cuss the sacrifice and cost to the patient as a result of our courage and our failures. Courage may also refer to the fortitude required to pur
Book Reviews
519
sue eradication of ametropia rather than less challenging and sight-threatening problems like cystoid macular edema or endophthalmitis. Benevolence is the requirement that one's efforts benefit society. The authors of this book would have the reader believe that the pursuit of maximally uncorrected visual acuity should be the new paradigm for ophthalmology. In this regard, the foreword discusses the advances in cataract surgery with respect to the classical economic law of diminishing returns. The ques tion not answered is whose returns are dimin ishing as our technology matures. Of course a healthy dose of rationalization never hurts the benevolence factor. The techniques described elegantly within this volume are capable of providing excellent visual function to each pa tient, but at what cost to the patient in terms of added risk and to society in terms of added expense? In summary, if one can get through the prop aganda presented in the introduction, this vol ume offers a wealth of information, presented with beautiful graphics, concerning the phacoemulsification and refractive surgery with a smattering of other techniques added for good form.
Neuro-Ophthalmology. A Practical Text. By Nan cy M. Newman. Norwalk, Connecticut, Appleton & Lange, 1992. 484 pages, index, illustrat ed. $85 Reviewed by ROBERT T. SPECTOR
Iowa City, Iowa Neuro-ophthalmology is a discipline that en compasses the entire field of medicine. Hence, no textbook on the subject can exist without certain limiting factors. In her preface, Dr. Newman states that this book is a pragmatic clinical guide to neuro-ophthalmic disorders. The book is divided into five major sections, organized in a thoughtful and coherent man ner, describing anatomical findings in both sys temic and local diseases of the eye. The excel lent comprehensive flow charts provide the resident in ophthalmology with differential di agnoses of complaints as well as the appropri ate investigative procedures to be performed in the examination. The charts take the reader through logical steps, depending on the cause of the abnormality. All the photographs and diagrams are extremely well done.
The chapters on corneal degenerations and dystrophies are a pleasure to read. Although not comprehensive, they are filled with illustra tive designs and photographs. Primary and systemic immunologie disorders are well cov ered. Chapters are included on endocrine disor ders, disorders of lipid and carbohydrate me tabolism, and other metabolic abnormalities. The survey of primary skin disorders with ocu lar effects is useful as are the sections on drugs and toxic and allergic reaction to topical medi cations. Overall, the goals of the author have been exceptionally well met. Residents and general ophthalmologists will find this a readable, in formative, and friendly text. For those wishing more extensive or source information, for those who specialize in corneal and external disease, for those wishing a review of the basic science literature, or for those interested in the cutting edge information, this is not the appropriate text. I would guess, however, that even these individuals will benefit from this useful book during the course of daily practice.
Grayson's Diseases of the Cornea, ed. 3. By Robert C. Arffa. Philadelphia, Mosby Year Book, 1991. 725 pages, index, illustrated. $169 Reviewed by RONALD D. PLOTNIK
Rochester, New York The preface to the third edition of this classic work describes the goals of the author: reada bility, single authorship, clinical orientation, a high number of quality illustrations, and the use of tables. It further states that the intended readership includes ophthalmology residents and the general ophthalmologist. Dr. Arffa has achieved these objectives remarkably well. Grayson's Diseases of the Cornea provides a review of corneal and external disease that is primarily clinical and practical. The text begins with a review of anatomy and physiology of the cornea, conjunctiva, eyelids, and tear film. Al though not comprehensive, the review contains excellent clinical correlations, numerous pho tographs, and well-drawn diagrams. The chap ter on history and examination is fairly com plete. It describes both simple and more complex examination techniques. Additionally, it includes differential diagnoses for various signs including cornea verticillata, crystalline keratoplasty, vascularization, and punctate keratitis. The chapter on laboratory evaluation is an informative review of cytologie techniques and their interpretation as well as culture, biop sy, and impression cytology techniques. The remaining chapters deal with the broad range of corneal and external disease. Congeni tal anomalies are reviewed in detail with many associated diagrams. Follicular, neonatal, and bacterial conjunctivitis are well covered in a multi-page table that details conjunctival and corneal signs, cytologie findings, etiologic fac tors, and other pertinent information. Noninfectious conjunctivitis is covered less thorough ly but is well organized and readable. Thorough tables relating to bacterial keratitis include such information as likely organisms, broadspectrum initial antibiotic coverage, prepara tion of fortified topical antibiotics, preparation of subconjunctival antibiotics, and approaches to antibiotic choice. The chapter on viral dis eases is clear, directed, and specific. A construct of appropriate treatment for infectious and im mune-related manifestations of herpes simplex is particularly straightforward and useful.
The Surgical Rehabilitation of Vision. Edited by Lee T. Nordan, W. Andrew Maxwell, and James A. Davison. New York, Raven Press, 1992. 375 pages, illustrated. $125 Reviewed by ERICH GROOS
Nashville, Tennessee The tone of this book is set by the editors' preface and the forewords. The goals of the text, stated in the first chapter, "The Phi losophy of Eye Sur gery," are based on the premise that ex cellence in surgical technique is re quired to reap the ultimate reward: the best uncorrected vision for the pa tient. The editors set out to provide under standing of the techniques necessary to 518
Vol. 114, No. 4
perform state-of-the-art anterior segment sur gery, to provide a comprehensive reference text on the subject, and to instill in the reader the goal of achieving excellence. Excellence, they state, is characterized by five key components: universality, essential knowledge, desire, cour age, and benevolence. Let us then examine the work within the framework of these character istic components. Universality implies that excellence may flourish within any area of human endeavor. This applies to refractive surgical skills no less than any other field. Essential knowledge is the foundation upon which excellence is built and is certainly the basis of any good text. The information within this book is well organized, attractively format ted, and well illustrated. The chapters in Sec tion 1, which deals with recent developments, cover a variety of topics ranging from optics to computers to perioperative anesthesia. Section 2, on surgical instrumentation, is particularly well written and contains a vast array of infor mation about instruments, sutures, and needles used in anterior segment surgery. Sections 3 and 4 deal with surgery of the lens. These sections comprise nearly half the book. The chapters on intraocular lenses and capsulorrhexis are replete with spectacular photographs of intraocular lenses, both virgin and in situ. The chapters that follow have a dizzying array of techniques for extraction of the human lens and the approach to associated surgical compli cations, including ametropia. Each chapter con tains an ample number of color plates depicting the steps in the procedures. The discussions are lucid and succinct. The chapters on corneal surgery deal primarily with techniques suited for refractive surgery as well as keratoplasty. The final chapters seem like afterthoughts to fill in the prerequisites for a text on anterior seg ment surgery. The chapter describing ap proaches to ptosis repair is well illustrated and well written but misplaced in a book about anterior segment surgery. Desire to be the best is a component of excellence that should lead the reader to desire the best outcome for the patient, that is, opti mal uncorrected visual acuity. Being the best by striving for excellence brings us to courage; meaning the courage to apply the best solutions despite the previous failures. Unfortunately, the authors do not dis cuss the sacrifice and cost to the patient as a result of our courage and our failures. Courage may also refer to the fortitude required to pur
Book Reviews
519
sue eradication of ametropia rather than less challenging and sight-threatening problems like cystoid macular edema or endophthalmitis. Benevolence is the requirement that one's efforts benefit society. The authors of this book would have the reader believe that the pursuit of maximally uncorrected visual acuity should be the new paradigm for ophthalmology. In this regard, the foreword discusses the advances in cataract surgery with respect to the classical economic law of diminishing returns. The ques tion not answered is whose returns are dimin ishing as our technology matures. Of course a healthy dose of rationalization never hurts the benevolence factor. The techniques described elegantly within this volume are capable of providing excellent visual function to each pa tient, but at what cost to the patient in terms of added risk and to society in terms of added expense? In summary, if one can get through the prop aganda presented in the introduction, this vol ume offers a wealth of information, presented with beautiful graphics, concerning the phacoemulsification and refractive surgery with a smattering of other techniques added for good form.
Neuro-Ophthalmology. A Practical Text. By Nan cy M. Newman. Norwalk, Connecticut, Appleton & Lange, 1992. 484 pages, index, illustrat ed. $85 Reviewed by ROBERT T. SPECTOR
Iowa City, Iowa Neuro-ophthalmology is a discipline that en compasses the entire field of medicine. Hence, no textbook on the subject can exist without certain limiting factors. In her preface, Dr. Newman states that this book is a pragmatic clinical guide to neuro-ophthalmic disorders. The book is divided into five major sections, organized in a thoughtful and coherent man ner, describing anatomical findings in both sys temic and local diseases of the eye. The excel lent comprehensive flow charts provide the resident in ophthalmology with differential di agnoses of complaints as well as the appropri ate investigative procedures to be performed in the examination. The charts take the reader through logical steps, depending on the cause of the abnormality. All the photographs and diagrams are extremely well done.