Colour Atlas of Ophthalmic Plastic Surgery, 2nd Ed. A. G. Tyers, J. R. O. Collin. Boston: Butterworth-Heinemann, 2001. Pages: 368. Price: 160. 00. ISBN 0-7506-4254-8. The goal of the authors was “…to provide surgical photographs sufficiently realistic in color and detail—and supported by key diagrams where necessary—so that the anatomy can be recognized at operation and each step of the procedure understood. ” Photographic documentation of surgical procedures is generally fraught with obstacles that are difficult to overcome. Conditions of the operating theater including poor lighting, small space, and sterile conditions are limiting. Standard camera equipment used in the office for perioperative facial photography may not be ideal in the operative setting. Any blood in the surgical field tends to wash out the photographs in a “sea of red, ” obscuring much of the anatomic detail. Finally, most patients do not wish to have their anatomy splayed open for hours on end while the stage is set for each photograph in a sequence of surgical steps. The authors, along with the Department of Medical Photography in Salisbury, should be commended for providing us with such remarkable photographic illustration of the majority of “bread and butter” ophthalmic plastic surgical procedures. Chapter 1 is a brief review of essential orbital and eyelid anatomy. Chapter 2 outlines basic techniques including wound closure, split and full-thickness skin grafts, and grafts used for reconstruction of the posterior lamella of the eyelid. Chapters 3 and 4 review the preoperative evaluation and anesthesia (local and regional blocks), respectively. Chapter 5 presents basic instrument sets that are required for ophthalmic plastic procedures. The rest of the atlas is dedicated to the predominant procedures for the most commonly encountered diagnoses. Each chapter begins with a brief introduction addressing choice of operation. The procedures are presented pictorially with descriptive dialog and interspersed schematic drawings to clarify anatomic detail. At the end of each procedure, there is a section titled “Complications and Management” aimed at avoidance and management of common pitfalls. Each chapter ends with a succinct list of references recognizing manuscripts in which each procedure was first described or later amended. Chapters 6 through 14 review entropion, ectropion, eyelash abnormalities, ptosis, blepharoplasty, eyelid retraction, evisceration, enucleation, exenteration, and anophthalmic socket abnormalities. Chapters 15 through 17 present techniques of eyelid reconstruction, including both anterior and posterior lamellae. Chapter 18 reviews miscellaneous conditions including canthal deformities and orbital decompression techniques. Ultimately, it is up to the surgeon to select an individualized approach that meets the expectations of the patient. The authors concede that the choice of procedures presented “…inevitably reflects our own practices…” Nonetheless, the scope of procedures covered is relatively broad with only a few exceptions. For example, they failed to illustrate a number of other approaches to orbital decompression surgery: the swinging eyelid flap or transantral approaches to the orbital floor, the transconjunctival caruncular approach to the medial wall, and the more aggressive approach to lateral wall decompression as recently described by Dr. Robert Alan Goldberg, to name a few. Also, I would have liked to have seen orbital blowout fractures addressed because they are relatively common and the surgical approaches to them are also useful in the repair of overaggressive orbital decompressions. Overall, I strongly recommend this atlas to anyone with an interest in ophthalmic plastic and reconstructive surgery. It complements more comprehensive textbooks in this area by providing superior photographic illustration of surgical anatomic detail; however, it does not preclude the need to spend time with an experienced preceptor. I have already found it useful as a teaching tool for residents and students as they prepare for the operating room on my service. Steven E. Katz William H. Havener Eye Center, Department of Ophthalmology, Columbus, Ohio
Steven E. Katz (Tue,) studied this question.