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Vitreous Loss After Intraocular Lens Implantation
150
AMERICAN JOURNAL OF OPHTHALMOLOGY
microbiological studies with gentamicin. J. Infect. Dis. 119:355, 1969. 3. Baum, J. L., Barza, M., Shushan, D., and Wein stein, L.: Concentration of gentamicin in experi mental corneal ulcers. Arch. Ophthalmol. 92:315, 1974. 4. Golden, B., and Coppel, S. P.: Ocular tissue absorption of gentamicin. Arch. Ophthalmol. 84: 792, 1970.
Vitreous Loss After Intraocular Lens Implantation Editor: I have read with great interest the arti cle entitled, "Endothelial damage associ ated with intraocular lenses" (Am. J. Ophthalmol. 81:482, 1976), by William M. Bourne and Herbert E. Kaufman. This subject is of great concern to me as a surgeon implanting intraocular lenses after extracapsular surgery. The degree of damage shown is severe and may be relat ed to the techniques employed, resulting in vitreous loss in two of five patients, rather than to the insertion of an intraocu lar lens. This rate of vitreous loss with extracapsular cataract extraction and lens implantation is greater than my own and not typical of the rates of all surgeons who implant intraocular lenses. I would prefer the article to have been entitled "Endothelial damage associated with in sertion of intraocular lenses with a 40% incidence of vitreous loss," because the techniques employed are not necessarily typical of lens implantation techniques other surgeons use after extracapsular surgery. N E I L H. J O S E P H ,
Omaha,
M.D.
Nebraska
Reply Editor: The point of our paper was that signifi cant endothelial cell loss occurred in all five patients with intraocular lenses despite the excellent clinical results in each case. The endothelial damage oc curred whether or not vitreous material
JULY, 1976
was lost during the procedure. The endo thelial cell loss seemed to be associated with intraocular lens insertion, since it did not occur in most routine cataract extractions when lenses were not insert ed. Our presentation was a clear demon stration of the value of specular microsco py for the visualization of endothelial damage associated with ocular surgical procedures. We were surprised by the results of our study of five patients with clear corneas after intraocular lens inser tion. Other surgeons may also be enlight ened by using similar examinations of their own patients. We are aware of more extensive unpublished studies of this type that also show significant endotheli al cell loss after intraocular lens implanta tion. W I L L I A M M. B O U R N E ,
Rochester,
H E R B E R T E. K A U F M A N ,
Gainesville,
M.D.
Minnesota M.D.
Florida
BOOK REVIEWS Pocketbook of Pédiatrie Antimicrobial Therapy. By John D. Nelson. Philadel phia, Pennsylvania, J. B. Lippincott Company Publishers, 1975. Paperbound, 42 pages, index. $1.50 This pamphlet contains useful infor mation concerning dosage, routes of the administration, and selection of antibiot ics that can be helpful in the management of infections for the pédiatrie practice. The text provides information concerning the dosage for initiating therapy before specific micro-organisms have been iden tified. Antibiotics are suggested for spe cific etiologic agents after they have been identified and therapy is also recom mended for clinical syndromes. The trade and generic names of all the antibiotics
AMERICAN JOURNAL OF OPHTHALMOLOGY
microbiological studies with gentamicin. J. Infect. Dis. 119:355, 1969. 3. Baum, J. L., Barza, M., Shushan, D., and Wein stein, L.: Concentration of gentamicin in experi mental corneal ulcers. Arch. Ophthalmol. 92:315, 1974. 4. Golden, B., and Coppel, S. P.: Ocular tissue absorption of gentamicin. Arch. Ophthalmol. 84: 792, 1970.
Vitreous Loss After Intraocular Lens Implantation Editor: I have read with great interest the arti cle entitled, "Endothelial damage associ ated with intraocular lenses" (Am. J. Ophthalmol. 81:482, 1976), by William M. Bourne and Herbert E. Kaufman. This subject is of great concern to me as a surgeon implanting intraocular lenses after extracapsular surgery. The degree of damage shown is severe and may be relat ed to the techniques employed, resulting in vitreous loss in two of five patients, rather than to the insertion of an intraocu lar lens. This rate of vitreous loss with extracapsular cataract extraction and lens implantation is greater than my own and not typical of the rates of all surgeons who implant intraocular lenses. I would prefer the article to have been entitled "Endothelial damage associated with in sertion of intraocular lenses with a 40% incidence of vitreous loss," because the techniques employed are not necessarily typical of lens implantation techniques other surgeons use after extracapsular surgery. N E I L H. J O S E P H ,
Omaha,
M.D.
Nebraska
Reply Editor: The point of our paper was that signifi cant endothelial cell loss occurred in all five patients with intraocular lenses despite the excellent clinical results in each case. The endothelial damage oc curred whether or not vitreous material
JULY, 1976
was lost during the procedure. The endo thelial cell loss seemed to be associated with intraocular lens insertion, since it did not occur in most routine cataract extractions when lenses were not insert ed. Our presentation was a clear demon stration of the value of specular microsco py for the visualization of endothelial damage associated with ocular surgical procedures. We were surprised by the results of our study of five patients with clear corneas after intraocular lens inser tion. Other surgeons may also be enlight ened by using similar examinations of their own patients. We are aware of more extensive unpublished studies of this type that also show significant endotheli al cell loss after intraocular lens implanta tion. W I L L I A M M. B O U R N E ,
Rochester,
H E R B E R T E. K A U F M A N ,
Gainesville,
M.D.
Minnesota M.D.
Florida
BOOK REVIEWS Pocketbook of Pédiatrie Antimicrobial Therapy. By John D. Nelson. Philadel phia, Pennsylvania, J. B. Lippincott Company Publishers, 1975. Paperbound, 42 pages, index. $1.50 This pamphlet contains useful infor mation concerning dosage, routes of the administration, and selection of antibiot ics that can be helpful in the management of infections for the pédiatrie practice. The text provides information concerning the dosage for initiating therapy before specific micro-organisms have been iden tified. Antibiotics are suggested for spe cific etiologic agents after they have been identified and therapy is also recom mended for clinical syndromes. The trade and generic names of all the antibiotics