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Wiederherstellende Operationen Bei Schädigungen and Erkrankungen der Augen
BOOK REVIEWS
940 WIEDERHERSTELLENDE
OPERATIONEN
BEI
SCHWEREN SCHÄDIGUNGEN U N D E R K R A N K U N G E N DER A U G E N .
By
N.
A.
Puckov-
skaja. Leipzig, Georg Thieme, 1965. Paperbound, 182 pages, 164 figures in black and white, 3 tables, references. P r i c e : Not listed. This book comes from the Filatov Institute and presents an excellent survey of the work done in Russia on keratoplasty. It was translated into German by Manigk and Günther of Greifswald. T h e monograph consists of three parts, the first of which is of greatest interest and importance. It gives a historical survey on the development of the techniques of keratoplasty in Russia. H e r e , for the first time we find published in a Western European language the various contributions by Russian ophthalmologists to this problem of ocular surgery. T h e bibliography is exhaustive and probably quite complete. T h e author complains that the Russian contributions are not well enough known or cited by the western authors. This is probably true but we have to keep in mind that, in addition to the difficulties of script and language, many of these contributions were published in journals of the Asiatic part of the Soviet Union and are probably hardly available in western European countries or in the United States. The second and third part of the book deal with technical aspects of reconstructive procedures on the conjunctiva and cornea. W e find here a strange mixture of aggressive, daring and superb surgical technique with some aspects of medical management which seem to be taken from past decades and centuries. ( T h e use of leeches, tissue therapy, osmosis therapy, etc.) The largest part of the book deals with the so-called "subtotal penetrating keratoplasty" as it is used in cases of corneal staphyloma and ectatic leukomas. The author uses a trephine of 8 to 10 mm diameter and leaves a rim of 1 to 2 mm of normal corneal tissue in the periphery. This report covers
the results of 100 such patients. I n 10% the graft remained clear or nearly clear. None of the patients had a preoperative vision better than counting fingers and most of them had only light perception with projection. Twenty-six of the patients had an improved vision after the operation. The poor visual end-result was not only due to the partial or complete opacification of the graft, but occasionally also due to an amblyopia because of the long-standing corneal opacity. Occasionally a second corneal transplant was done. This was usually a smaller one and, interestingly enough, in these small grafts apposition is achieved by a conjunctival flap and not by any sutures. Occasionally it was necessary, because of the size of the staphyloma, to transplant the entire cornea with a rim of scierai tissue. This usually does not lead to an improvement of vision but is merely a cosmetic procedure. T h e third part of the book deals with reconstructive surgery of conjunctiva and cornea after extensive thermal or chemical injuries. A total symblepharon is operated upon by transplantation of mucosal membranes from the lips. This is usually done in two stages. During the first stage the bulbar conjunctiva is replaced. The mucosal membrane is here anchored to the episclera. In the second stage the conjunctiva is replaced over the back surface of the lids. F o r a long time the palpebral margin remains closed. The conjunctival reconstruction is often followed by an extensive lamellar keratoplasty. H e r e again, only the largest ones are secured by direct sutures. Smaller ones are secured by overlying cross-sutures or an egg membrane. Somewhat more controversial are the peripheral, lamellar keratoplasty and the keratoplasty done for a biologic improvement of the scar. In the first instance it is hoped that from a small peripheral area of clear cornea a better bed for future transplantations can be obtained when the first operation consists
BOOK REVIEWS only of a peripheral, lamellar transplant. The second operation is usually a simple lamellar keratoplasty. Frederick C. Blodi.
PROCEEDINGS OF THE ALL-INDIA O P H T H A L MOLOGICAL SOCIETY. VOLUME X X , 1 9 6 2 .
Madras, Diocesan Press, 1964. Clothbound, 146 pages. Price: Not listed. Almost the first half of this XX volume of the proceedings of the All-India Ophthalmological Society, which has an impressively long membership list, is concerned with a symposium on perimetry. The subjects of the articles in this portion range from an introduction to perimetry to clinical discussions of field changes. The remainder of the volume contains articles on cataracts, uveitis, squint and, of course, pleoptics. Thomas Chalkley.
DlAGNOSTICA U L T R A S O N I C A
IN
OPHTHAL-
Edited by W. Buschmann and I. Hildebrandt. Berlin, Humberboldt University Press, 1965. Paperbound, 226 pages, 319 figures in black and white, 14 tables, references. Price: Not listed. The collection of 46 papers represents the most complete and the most eloquent exposition to date of the role of ultrasound in diagnosis and treatment of eye disease. The reports, all of which are relatively brief, were prepared for presentation at a symposium held at East Berlin's Humberboldt University in June, 1964. There are multiple presentations by the same author and almost 20% of the 46 papers come from Humberboldt University. However, this seems justified by the degree of activity in MOLOGIA.
941
East Berlin in the field of ultrasound. Further, the two most experienced investigators in the subject area from western countries, Oksala of Finland and Baum of the United States, are represented by papers. There are contributions from London, Edinburgh, Australia, Kingston (Ontario) and Chicago as well as from Eastern Europe. The presentations are both varied and authoritative. They are required reading for anyone planning investigation of ultrasonics and the eye. Albert M. Potts. By Ferenc Kiss, M.D., and Janos Szentagothi, M.D., Budapest, Hungary. New York, The Macmillan Company, 1964, three volumes, 17th edition, index. Price: Not listed. The first volume of this impressive atlas of human anatomy contains 316 pages and covers osteology and mycology; the second volume (229 pages), splanchonology, the ductless glands and the heart ; the third volume (326 pages), the nervous system, angiology and the sense organs. The figures, in black and white and in color, are printed on fine gloss paper, and the legends are in large, easy-to-read print. Volume 3 has a 16-page section dealing with the anatomy of the eye and adnexa. Figure 221, page 212, which depicts in color a horizontal section of the eye with its complete arterial and venous blood supply, was unusually helpful. Although I wish that this Atlas had been available when I was a medical student, I feel that it has limited value for the practicing clinical ophthalmologist. Joseph E. Alfano.
ATLAS OF H U M A N ANATOMY.
940 WIEDERHERSTELLENDE
OPERATIONEN
BEI
SCHWEREN SCHÄDIGUNGEN U N D E R K R A N K U N G E N DER A U G E N .
By
N.
A.
Puckov-
skaja. Leipzig, Georg Thieme, 1965. Paperbound, 182 pages, 164 figures in black and white, 3 tables, references. P r i c e : Not listed. This book comes from the Filatov Institute and presents an excellent survey of the work done in Russia on keratoplasty. It was translated into German by Manigk and Günther of Greifswald. T h e monograph consists of three parts, the first of which is of greatest interest and importance. It gives a historical survey on the development of the techniques of keratoplasty in Russia. H e r e , for the first time we find published in a Western European language the various contributions by Russian ophthalmologists to this problem of ocular surgery. T h e bibliography is exhaustive and probably quite complete. T h e author complains that the Russian contributions are not well enough known or cited by the western authors. This is probably true but we have to keep in mind that, in addition to the difficulties of script and language, many of these contributions were published in journals of the Asiatic part of the Soviet Union and are probably hardly available in western European countries or in the United States. The second and third part of the book deal with technical aspects of reconstructive procedures on the conjunctiva and cornea. W e find here a strange mixture of aggressive, daring and superb surgical technique with some aspects of medical management which seem to be taken from past decades and centuries. ( T h e use of leeches, tissue therapy, osmosis therapy, etc.) The largest part of the book deals with the so-called "subtotal penetrating keratoplasty" as it is used in cases of corneal staphyloma and ectatic leukomas. The author uses a trephine of 8 to 10 mm diameter and leaves a rim of 1 to 2 mm of normal corneal tissue in the periphery. This report covers
the results of 100 such patients. I n 10% the graft remained clear or nearly clear. None of the patients had a preoperative vision better than counting fingers and most of them had only light perception with projection. Twenty-six of the patients had an improved vision after the operation. The poor visual end-result was not only due to the partial or complete opacification of the graft, but occasionally also due to an amblyopia because of the long-standing corneal opacity. Occasionally a second corneal transplant was done. This was usually a smaller one and, interestingly enough, in these small grafts apposition is achieved by a conjunctival flap and not by any sutures. Occasionally it was necessary, because of the size of the staphyloma, to transplant the entire cornea with a rim of scierai tissue. This usually does not lead to an improvement of vision but is merely a cosmetic procedure. T h e third part of the book deals with reconstructive surgery of conjunctiva and cornea after extensive thermal or chemical injuries. A total symblepharon is operated upon by transplantation of mucosal membranes from the lips. This is usually done in two stages. During the first stage the bulbar conjunctiva is replaced. The mucosal membrane is here anchored to the episclera. In the second stage the conjunctiva is replaced over the back surface of the lids. F o r a long time the palpebral margin remains closed. The conjunctival reconstruction is often followed by an extensive lamellar keratoplasty. H e r e again, only the largest ones are secured by direct sutures. Smaller ones are secured by overlying cross-sutures or an egg membrane. Somewhat more controversial are the peripheral, lamellar keratoplasty and the keratoplasty done for a biologic improvement of the scar. In the first instance it is hoped that from a small peripheral area of clear cornea a better bed for future transplantations can be obtained when the first operation consists
BOOK REVIEWS only of a peripheral, lamellar transplant. The second operation is usually a simple lamellar keratoplasty. Frederick C. Blodi.
PROCEEDINGS OF THE ALL-INDIA O P H T H A L MOLOGICAL SOCIETY. VOLUME X X , 1 9 6 2 .
Madras, Diocesan Press, 1964. Clothbound, 146 pages. Price: Not listed. Almost the first half of this XX volume of the proceedings of the All-India Ophthalmological Society, which has an impressively long membership list, is concerned with a symposium on perimetry. The subjects of the articles in this portion range from an introduction to perimetry to clinical discussions of field changes. The remainder of the volume contains articles on cataracts, uveitis, squint and, of course, pleoptics. Thomas Chalkley.
DlAGNOSTICA U L T R A S O N I C A
IN
OPHTHAL-
Edited by W. Buschmann and I. Hildebrandt. Berlin, Humberboldt University Press, 1965. Paperbound, 226 pages, 319 figures in black and white, 14 tables, references. Price: Not listed. The collection of 46 papers represents the most complete and the most eloquent exposition to date of the role of ultrasound in diagnosis and treatment of eye disease. The reports, all of which are relatively brief, were prepared for presentation at a symposium held at East Berlin's Humberboldt University in June, 1964. There are multiple presentations by the same author and almost 20% of the 46 papers come from Humberboldt University. However, this seems justified by the degree of activity in MOLOGIA.
941
East Berlin in the field of ultrasound. Further, the two most experienced investigators in the subject area from western countries, Oksala of Finland and Baum of the United States, are represented by papers. There are contributions from London, Edinburgh, Australia, Kingston (Ontario) and Chicago as well as from Eastern Europe. The presentations are both varied and authoritative. They are required reading for anyone planning investigation of ultrasonics and the eye. Albert M. Potts. By Ferenc Kiss, M.D., and Janos Szentagothi, M.D., Budapest, Hungary. New York, The Macmillan Company, 1964, three volumes, 17th edition, index. Price: Not listed. The first volume of this impressive atlas of human anatomy contains 316 pages and covers osteology and mycology; the second volume (229 pages), splanchonology, the ductless glands and the heart ; the third volume (326 pages), the nervous system, angiology and the sense organs. The figures, in black and white and in color, are printed on fine gloss paper, and the legends are in large, easy-to-read print. Volume 3 has a 16-page section dealing with the anatomy of the eye and adnexa. Figure 221, page 212, which depicts in color a horizontal section of the eye with its complete arterial and venous blood supply, was unusually helpful. Although I wish that this Atlas had been available when I was a medical student, I feel that it has limited value for the practicing clinical ophthalmologist. Joseph E. Alfano.
ATLAS OF H U M A N ANATOMY.