Microsoft Word - OPH054BF

Book Reviews Livres nouveaux · Buchbesprechungen Stephen L. Bosniak (ed) Complex Socket Deformities Advances in Ophthalmic Plastic and Reconstructive Surgery McGraw-Hill Medical Publ.. Nürnberg 1992. IX+ 310 pp. ISBN 0–07–105383–2 The actual contributions are introduced by a reprint of Kennedy’s important paper (Trans Am Ophthalmol Soc 1964;62:469–510). He summarized the international knowledge about the effect of early enucleation on the growth of the orbit in the rabbit and cat. The age distribution at the time of enucleation is demonstrated in 42 human patients. Dootz demonstrates the early use of expansion treatment in congenital anophthalmos and microph-thalmos among infants. Techniques and results of progressive-sized hard conformers and lid expansion devices by the ocularist are demonstrated. Downes, Lavin and Collin present a series of 38 patients with 57 congenitally contracted sockets. The use of a hydrophilic expander in the severely contracted anophthalmic socket with marked lid phimosis enable subsequent fitting and retention of a hard conformer in many of these cases, thus obviating early surgery. Small et al. developed an expansion prosthesis for the anophthalmic or microphthalmic socket that is demonstrated in a case report. Morax and Hurbli executed a three-stage treatment of severe cases with congenital anophthalmos and mi-crophthalmos: (1) orbital expansion by surgery; (2) eyelid reconstruction, (3) final corrections (ptosis, en-tropion). Two cases with excellent results are reported in detail. Two cases of congenital symblepharon (variant of cryptophthalmus) are reported by Morax et al. Surgical treatment including expansion of the conjunctival for-nix and reconstruction by inferior eyelid flap are demonstrated. Kaltreider gives the history of the myofibroblast (Gabbiani 1971) and its significance for socket contraction – an important aspect. In 17 patients with shortening of the conjunctival fornices by symblepharon or scar formation, Karesh et al. used 0.5-mm thick mucous membrane grafts sutured to the resected socket and splinted in place by a custom-designed conformer instead of full-thickness mucosa with followup between 6 and 76 (mean 29.8) months (a tecnique we have found very practicable for 28 years). Putterman et al. describe their technique of socket reconstruction in 47 severe cases over a 10year period. A large C-shaped conformer is wrapped with a large full-thickness oral mucosa graft, after all cicatricial tissue within the socket was excised. This unique conformer directs its force both vertically and deeply posteriorly. Authors were able to successfully reform spacious and stable fornices in 40 of 41 severely contracted sockets. 6 patients with inadequate follow-up were excluded. Bonavolonta used the temporal muscle to provide a well-vascularized bed for reconstruction of severely contracted sockets following irradiation.