Complications in Phacoemulsification: Avoidance, Recognition, and Management. William J. Fishkind, ed. New York: Thieme, 2002. Pages: 304. Price: $149.00. ISBN 0-86577-959-7.
A textbook that deals with the recognition and management of surgical complications is very helpful, but a book, such as this, that also stresses the prevention of complications is invaluable. This textbook encompasses virtually every aspect of modern cataract surgery within its succinct 31 chapters ranging from discussions of ophthalmic anesthesia to surgical techniques. Dr. Fishkind does an admirable job editing the work of his 31 contributors into a concise whole. The tone of the text is informal overall, and I found it to be appealing and quite readable. The chapters are not exhaustive treatises on their subjects, but rather practical, manual-style approaches. The references are helpful without being overwhelming. Equally important is the superb quality of the medical illustrations, which are provided by Tony Pazos. These are detailed, clear, accurate, and consistent from chapter to chapter, despite various authors. Also included are also numerous well-produced photographs that compliment the text and the illustrations.
Unlike other texts dealing with complications of cataract surgery that stress postoperative management, this text focuses on preoperative and intraoperative recognition and management (as the title suggests). As such, it will be most valuable to the ophthalmology resident and neophyte ophthalmic surgeon. An experienced anterior segment surgeon may also benefit from this symposium written by the leaders in the field. Optometrists, optometry students, and medical ophthalmologists who are involved in preoperative and postoperative care would benefit from the discussions even though the thrust of the book is oriented toward the surgeon.
The chapters on ophthalmic anesthesia are well done, delivering a good description of regional and topical approaches, along with the risks of each. Dr. Koch’s chapter, “Vitrectomy Following Vitreous Loss,” is a gem that describes techniques backed up by theory in a comprehensible fashion. Descriptions and management of suprachoroidal hemorrhage, endophthalmitis, retained nuclear fragments, and dislocated intraocular lens are amply introduced in the chapter “Posterior Segment Complications.”
A unique feature of this textbook is the collection of four chapters at the end of the book entitled “Prevention Pearls and Damage Control: Parts 1 to 4.” These chapters describe an individual surgeon’s approach to cataract surgery, along with that surgeon’s recommendations for avoiding complications. Although the chapters are somewhat redundant, they are nonetheless useful in that they describe a single, well-respected surgeon’s approach to cataract surgery from beginning to end.
This text succeeds in its goal of describing techniques to prevent and manage surgical complications with cataract surgery. It is quite readable, and I believe that the discussions will hold up well with the passage of time even though individual techniques will change. The inclusion of a video collection of the described techniques would be a welcome addition, but would obviously add to the cost of the text. The illustrations are particularly well produced and contribute immensely to the overall excellence of this textbook.