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  • Problems in Periorbital Surgery: A Repair Manual

Problems in Periorbital Surgery: A Repair Manual
Reviewed by Raman Malhotra

1 April 2020 | Raman Malhotra | EYE - Oculoplastic, EYE - General
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This is a multi-author textbook directed at oculoplastic and plastic surgeons carrying out and managing aesthetic eyelid surgery. The authors are well-known and commonly cite their mentor, Clinton (“Sonny”) McCord as the main inspiration behind the textbook.

Each section contains a clinical scenario accompanied by good quality photographs. The reader is then taken through the management of the case. The layout is clear, making it easy to follow and read. Furthermore, online videos are available and the quality of these is excellent with clear narration. A particularly valuable section of the book is the chapter on filler-related complications.

Given the target audience is specialists in oculoplastics and general plastics rather than generalists, some areas may appear too basic. For example, with scar management, the authors nicely summarise the controversy regarding the role of intralesional 5-FU. However, it would have been a great opportunity to evaluate the published evidence on use of various applications / creams / natural remedies, etc. and even intralesional botulinum toxin.

The chapter ‘Post-blepharoplasty ptosis’ describes traditional procedures but lacks details on alternative posterior-approach procedures that have been published in the last 10 years. The chapter ‘The missed ptosis in upper eyelid blepharoplasty’ is well written with excellent images. However, in the section ‘Prevention’, the role of a unilateral phenylephrine test in the preoperative assessment is not even given a mention. Adding this could be considered in a subsequent edition as a valuable way of identifying a subtle, latent or micro-ptosis.

In the chapter ‘Post-blepharoplasty lagophthalmos’, the author advocates and demonstrates the use of a skin graft placed in the upper eyelid skin crease. Although in the suggested reading they direct the reader to an article describing and advising the placement of grafts into a supraciliary incision, they fail to highlight any detail on this technique or its advantages. This is an important distinction, perhaps a superior option, and certainly one that most surgeons nowadays consider a superior option in contrast to placing a graft in the skin crease.

The chapter on epiphora is very short indeed given the plethora of causes and considerations. It is perhaps more of a brief overview for non-ophthalmic clinicians.

In many ways, commentaries by other authors to each chapter would have perhaps addressed the criticisms above, but if included would certainly enhance the value of a second edition.

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Raman Malhotra
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Raman Malhotra

Queen Victoria Hospital, East Grinstead, UK.

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Problems in Periorbital Surgery book cover

Book Details

Author: Foad Nahai, Ted H Wojno


Reviewed by: Raman Malhotra


Published by: Thieme


Format: Hardback


ISBN: 9781626237087


Description:
Date of publication: 2018


Price: £191.50


Value Rating: 3/5


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