Manual of retinal surgery

Abstract

Andrew J. Packer Manual of retinal surgery, 2nd ed. Butterworth-Heinemann, 2001Isbn: 0750671068Price: £ 25.00 This book of 137 pages is a manual in the sense a book limited to the important facts and necessary instructions to accomplish tasks as defined in the foreword by Th. Aaberg. The manual consists of 10 chapters written by 13 American retinal specialists. The first three chapters deal shortly with surgical anatomy, preoperative clinical examination, echografic and electrophysiological investigation. These subjects are covered only to the extent of practical use for planning surgical intervention. In the next chapters the different vitreo-retinal procedures are described in detail. In management of retinal breaks, cryopexy and laser photocoagulation is presented in a balanced way, with pros and cons for both methods. Pneumatic retinopexy has a fine protocol, but recommendation of the method also to multiple breaks separated by up to 180 degrees, giant tears and macular holes is in my opinion a little over enthusiastic. Anaesthesia gives a good scoring system to select patients for local versus general anaesthesia. In chapter 7 scleral buckling surgery is covered exstensively and my only objection concerns the injection of air after the buckle has been sutured in place. Instead I prefer to inject air immediately after the release of subretinal fluid to avoid wrinkling of the retina over the buckle, as also described in the chapter of managing complications. Posterior segment vitrectomy gives us the instruments and methods for the most commonindications. A description of the technique for endophthalmitis is missing, the author finding it beyond the scope of this book. Some of the difficulty of identifying remaining vitreous can be overcome by injection of fluorescein in the vitreous. The new chapter of macular hole surgery tells the principles of today's surgery The different vitreous substitutes are dealt with mainly under posterior segment surgery. As they are referred to in other chapters and only shortly covered in many textbooks, a separate chapter describing the physical and chemical properties of air, gasses, water and fat-soluble substitutes used in the vitreous might have been an idea. In conclusion the manual gives an excellent introduction and a detailed overview to retinal surgery and can be recommended to residents starting in the vitreo-retinal unit, to OR-personal and to the surgeon in charge of the department's manual collection.