Cataract Surgery: Technique, Complications, Management, 2nd Editon
Roger F. Steinart, editor. Philadelphia: Elsevier, 2004. Pages: 752. Price:$ 125.00. ISBN 0–7216–9057–2.
Cataract Surgery: Technique, Complications, Management, second edition, is the updated version of a textbook used to teach the evolving techniques and the perioperative management of cataract surgery. The authors’ goal for this edition was “not only to update that text, but also to include virtually all the nuances of cataract surgery and its complications in a variety of settings.” The incorporation of many contributing authors in creating this edition helps to achieve this goal by providing a diversity of experience with procedure variations, treatment of complications, and future innovations. These diverse backgrounds prove helpful to optometrists who are involved in the perioperative management of cataract patients.
As compared to other textbooks, Cataract Surgery: Technique, Complications, Management provides a well-organized template for finding information. The text begins with the evaluation of cataracts, and then discusses the preparation for surgery. These are probably the most relevant sections for the optometrist, yet the authors do not embellish on such concepts, preferring to summarize the material with a brief discussion on anatomy, histology, biochemistry, physiology, and pathology. The chapter dealing with the selection of the intraocular lens (IOL), however, spends a significant amount of time on different calculations that can be performed to determine IOL power.
The next section discusses preparation for surgery and begins with a complete synopsis of the properties of ophthalmic viscosurgical devices, needles, and suture materials. The chapter addressing the Phaco machine is quite in-depth and may be useful in discussions with patients requesting information about the equipment being used. The chapters regarding anesthesia include detailed graphics explaining techniques as well as variations used by surgeons.
Sections three and four address the indications and techniques of extracapsular cataract extraction and phacoemulsification. These sections utilize many clear and concise illustrations and photographs to assist in conveying the information outlined in the book’s text. Section five dedicates 15 chapters to special techniques and includes such topics as retained lens fragments, small pupils, combined cataract/glaucoma procedures, pediatrics, and trauma. Of particular interest to optometrists are the chapters regarding astigmatism control (which include two different arcuate incision keratotomy nomograms based on location) and ocular comorbidities, namely ocular surface problems, diabetes, retinitis pigmentosa, eyelid abnormalities, and bleeding disorders. The ocular comorbidity chapter is well organized, highlighting preoperative, surgical, and postoperative considerations. My only criticism is that not enough conditions have been included, nor is there enough information included relative to the conditions. Collagen vascular disorders are something that could perhaps be included in a future edition.
The next section details the interesting evolution of the IOL leading to the many options currently available to surgeons today, including foldable and multi-focal lens technologies. However, there is only a brief discussion of some of the newest lenses that are currently available, including the Crystalens AT-45 from Eyeonics (formerly C&C Vision).
Section seven deals with the management of complications, beginning with intraoperative issues, surgical repositioning of the lens, and wound dehiscence. The next several chapters deal with corneal edema and postoperative glaucoma, proving to be relevant to the postoperative care provided by optometrists, even though an emphasis is given to those complications requiring surgical treatment.
The last section, covering innovations and future trends for cataract extraction, traditionally proves to be the most challenging for textbook authors since the publishing process is often time-consuming and many of the future innovations come to fruition prior to the book being published. This textbook is no exception; however, the contributing authors have done an excellent job in referencing recent journal publications.
Cataract Surgery: Technique, Complications, Management, second edition, is designed to be a complete reference source for cataract surgery related issues, and in that regard, I think the book is a success. More information could be included regarding new technologies or future advances, particularly in the area of IOLs. Additionally, the text focuses on surgical technique more heavily than the perioperative management that could be the optometrist’s responsibility. However, the completeness of this textbook makes this a helpful reference for the optometrist’s perioperative care of cataract patients.
Thomas M. Chester
Cleveland Eye Clinic