Complications in Ophthalmic Plastic Surgery

Bristol Eye Hospital, Lower Maudlin Street, Bristol BS1 2LX, UK; nikocha@hotmail.com

Ed by B G Brazzo. Pp 264; ￡130.50 (169.95). New York: Springer Verlag, 2003. ISBN 0-387-00283-9.

There in no doubt that complications in surgery are an inevitable fact.

Nevertheless, the unforeseen surgical outcomes always play a fundamental part in the self improving process. Certainly, the experience provides the safest way, for both the patient and the surgeon, to prevent harm and smooth the final result.

This book represents one of the most serious, and not very common, works focusing on the complications in ophthalmic plastic surgery. It is a considerably well organised book, which apparently requires some basic knowledge of oculoplastics and facial aesthetic surgery. The format is based on three distinguished parts: cosmetic surgery, ptosis, and lower eyelid malposition. A very competent number of contributors cover the topics of their specific interest. In the first part the authors are dealing with the blepharoplasties, the laser resurfacing, and the forehead lift. The ptosis chapter is referred to the most common ptosis techniques but brow suspension is remarkably absent. The third part, although it is entitled "Lower eyelid malposition," includes and some unrelated, though welcomed topics, like DCR, enucleation, and orbital fractures.

The necessity of the communication between the surgeon and the patient is vigorously emphasised and didactically analysed in every single chapter. Deep understanding of the patient’s expectations as well as detailed information about the pragmatic results is recommended throughout the chapters of the book. There is quite a sufficient reference to preoperative evaluation of the patient regarding measurements, anaesthesia, and surgical preparation.

Although the covered operations are extensively described, a countable number of other surgical techniques, and their possible complications, are not mentioned. The latter is probably related to the editor’s orientation to aesthetic oculoplastic surgery.

The anatomical and pathophysiological mechanisms of the most common complications are thoroughly explained. At the same time, the authors give many enlightening tips, based on their broad experience, for preventing the problems, and meticulously describe the management of the intraoperative and postoperative complications. The number of the illustrations do not adequately correspond to the addressed complications and the quality of the pictures varies, depending on the author’s collection. Additionally, the shortage of

references in some of the most interesting chapters (ptosis, enucleation) should certainly not be overlooked, for the magnitude of such a book.

Every attempt to give precious advice about the frustrating and unavoidable surgical complications is always warmly welcomed. Brian Brazzo’s book is predominately a useful guide to the understanding, prevention, and management of the commonest problems in oculoplastic surgery. Despite the expected problems of every first edition this generally represents a meticulous work on specific issues and thus is recommended for the ophthalmic surgeon and especially for surgeons who are chiefly interested in oculoplastics and cosmetic surgery.