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Oculoplastic surgery: review 1
  1. Jane Olver
  1. Western Eye Hospital and Eye Department Charing Cross Hospital, London

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    Brian Leatherbarrow. Pp 376; £150.00. London: Martin Dunitz, 2002. ISBN 1-85317-942-6

    This is a wonderfully detailed book by an experienced oculoplastic and orbital surgeon. It is remarkable, as most mortal oculoplastic surgeons would have struggled over 10 years to write such a book, but Brian Leatherbarrow has succeeded in concentrating his encyclopaedic knowledge into a comprehensive tome in only two years. The result is a first class book, consisting of 26 chapters, 364 pages, and over 1200 original colour drawings, clinical photographs, and black and white diagrams.

    The book is logically organised with an introductory chapter, which outlines basic principles and distils these into simple oculoplastic aphorisms. This leads nicely into 10 chapters on common oculoplastic conditions: the eyelid malpositions (ptosis, entropion, and ectropion), facial palsy, and periocular tumour management/reconstruction. The book then gradually develops the link between oculoplastics and orbital surgery with five chapters on trauma: of the eyelid, simple orbital fractures, zygomatic fractures, and more complex orbital fractures. Even if you are not going to perform this type of surgery, it is worthwhile having an idea of what is involved.

    There are then three very sound chapters on orbital surgery; assessment and principles, the options for surgical approaches to the orbit and the management of thyroid eye disease. Again there is this effortless, but essential, link between orbit and eyelid, with thyroid eyelid retraction correctly being covered here.

    The lacrimal surgery chapter is comprehensive and is well illustrated.

    Interestingly, blepharoplasty and eyebrow ptosis are placed quite late in the book, which initially seemed a little unusual. In fact, it is sensible, as both of these require the surgeon to have a deeper knowledge of brow and orbit anatomy, not least to manage potential complications. The illustrations of brow anatomy and the various approaches to brow ptosis are fabulous, and include up to date endoscopic techniques.

    The chapters on enucleation, exenteration, and socket work are very sound, as is the final chapter on autogenous grafts, which should be read frequently.

    Who is this book aimed at? Perhaps not the beginner, though if I were starting out now I would find this book, particularly with its fresh colour drawings, extremely helpful and inspirational. It is definitely a must as a reference for difficult cases and is also very practical to dip into, particularly before doing an operation that perhaps the surgeon has not performed for a few weeks or months.

    Every ophthalmologist interested in oculoplastic surgery should seriously consider obtaining a copy of this book. There are so many tips in it, each time I open it I learn something new, even something as simple as using a piece of Steri-drape to mark the template for a skin graft.

    The pictures and text are precise, clear, and uncluttered. I could hardly find any errors, perhaps figure 1.35 A and B should have been reversed (publisher’s error?) and I am not sure I entirely agree about starving patients for 24 hours after a lateral orbitotomy, but I’ll think about it.

    I look forward to future editions.

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