VOL. 70, NO. 6 BOOK REVIEWS 102S

B O O K R E V I E W S

N E R V U S O P T I C U S U N D E X P E R I M E N T E L L E S

T R A U M A , M O N O G R A P H I E N AUG DEM G E ­

SAMTGEBIETE DER NEUROLOGIE U N D P S Y ­

CHIATRIE, H E F T 131. By Wolfgan Schlote. Berlin, Springer-Verlag, 1970. Paper-bound, 158 pages, black-and-white illus­trations. $18.70.

This is a detailed, well-designed neuro-pathologic study of traumatic changes in the optic nerve of the white rat. The optic nerve serves here as a model for similar changes in the white substance of the brain. The reac­tions are, however, more clear-cut as no adjacent brain tissue has to be damaged.

The injuries were either a complete t ran-section (or severe crushing) , an incomplete transection (or mild crushing) , or a slight squeezing only. The last two injuries leave the artery of the optic nerve undamaged and ischémie processes can therefore be excluded.

Both ends of the cut or crushed nerve were carefully studied over a period of time. Light microscopic, histochemical and electro-microscopic studies were carried out. Spe­cial attention was paid to reactive changes. T w o kinds of pathways for the transport of substances in an axon are proposed: a longi­tudinal one (proximo-distal) and a t rans­verse one. Three types of myéline degenera­tion are described.

All in all, this is a monograph of exem­plary thoroughness covering many aspects of trauma to the optic nerve. I t is a credit to the Institute of Brain Research of the Univer­sity of Tuebingen.

Frederick C. Blodi

CIRUGIA DEL SEGMENTO A N T E R I O R DEL O J O .

By Joaquin Barraquer and Joaquin Rutl-lan. Barcelona, instituto Barraquer, 1969. Clothbound, 425 pages, 267 figures, 41 color plates.

This is the second book of the series of three volumes on Surgery of the Anterior Segment that Joaquin Barraquer and Joa­

quin Rutllan are preparing. The first volume, which was excellent, and published both in English and Spanish, covered the fundamen­tals of anterior segment surgery and intra-capsular cataract extraction.

This second volume is dedicated exclu­sively to surgery of the cornea, and it is really superb. I t covers all aspects of the sub­ject, not only the extraordinary technical developments that have been made available to us in the past few years, clearly presented and fully illustrated as performed by a mas­ter surgeon such as Joaquin Barraquer, but the book presents the most modern concepts on the biologic and pathologic aspects related to keratoplasty and transparency of the cor­nea. In 18 chapters and 270 illustrations, the authors give a full coverage of the pre-and postoperative management, step-by-step surgical techniques, indications and contra­indications for keratectomies, conjunctival plastic procedures, lamellar and penetrating corneal grafts, and a detailed consideration of the causes and pathogenesis of complica­tions and how to avoid them.

Joaquin Barraquer and Joaquin Rutllan have given us a masterpiece on the subject, which will soon be available in English also.

Benjamin F . Boyd

T H E R A P I E DER A U G E N K R A N K H E I T E N , M I T

DIAGNOSTISCHEN HINWEISEN. By Rudolf Thiel. Stuttgart, Georg Thieme Verlag, 1970. Paperbound, 527 pages, subject in­dex.

This book is a legacy of Rudolf Thiel and was left incompleted when death interrupted his work in 1967. Professor Hollwich from the University of Münster has completed and updated the work of his former teacher. Thiel, through whom this reviewer had his first memorable (and far from gentle) con­tacts with ophthalmology as à medical stu­dent, was a masterful clinician and diagnos­tician.

This book was designed as a primer for

1026 AMERICAN JOURNAL OF OPHTHALMOLOGY DECEMBER, 1970

the practitioner, to be used in conjunction with Thiel's Atlas of Eye Diseases, which has become a classic. The present work clearly reflects the large clinical experience of its author, and it contains a concise and easily accessible summary of clinical and diagnostic features followed by therapeutic information. The 12 chapters deal with dis­eases of the eyelids, lacrimal apparatus, orbit, conjunctiva, cornea, sciera, iris, lens, vitre­ous, optic nerve, retina, and choroid. The suggestions for medical or surgical treatment are in line with the most recent advances in ophthalmology.

The disadvantages of this book (other than its not being in English) are that no bibliography is included, and that the drugs are listed mostly by trade names rather than by their generic names. Thus, the therapeutic information is of limited use to the Ameri­can ophthalmologist, even when he can over­come the language barrier, for most of the drugs listed are known under different names in this country. It is safe to predict, however, that this book will be eminently successful as a standard source of reference in German-speaking countries, both for the ophthalmolo­gist-in-training and the practitioner.

Gunter K. von Noorden

GESCHWULSTE DER AUGENHOHLE UND IHRE OPERATIVE BEHANLUNG. By Harry Men­nig. Leipzig, Georg Thieme, 1970. Cloth-bound, 424 pages, black and white illustra­tions, 47 color plates, author and subject index. This is certainly a most interesting, stimu­

lating, and at times, shocking book. As the title indicates, the book consists of two main parts: a discussion on orbital tumors and a description of their surgical treatment.

The basic discussion on orbital tumors is excellent. The cases reported are based on the author's own experience during a 10-year period at the University of Berlin. All in all, 148 patients are described, of which 126 were operated on. The cases are interest­

ing, precisely described, and well illustrated. Sketches of the location of the tumor in the orbit accompany each case and these are most informative. The color pictures are of poor quality. This fault does not lie with the author, but with the publishing company. The absence of histopathologic pictures is perhaps somewhat disturbing for anybody interested in ocular pathology, but this as­pect of orbital lesions was obviously outside the scope of this book.

Among the 123 orbital lesions operated on were 64 that the author calls "primary" or­bital tumors. Into this group he also puts in­traocular tumors invading the orbit. The most frequent benign orbital tumor was again the hemangioma. Included in this group were also meningiomas, orbital pseu-dotumors, eosinophilic granulomas, and other similar lesions.

Twenty of the cases were malignant. The classification here is not very clear and not according to the generally accepted patho­logic groupings. A number of these lesions were primarily intraocular (three melanomas and one retinoblastoma).

Only four patients with malignant orbital lesions had clinically manifest lymph node métastases. These are, therefore, quite rare and the author advises against a prophylactic radical neck dissection. In general, he finds the prognosis of these tumors poor. Out of 16 operated patients who could be followed, only four appeared cured after five years. This could be due either to the fact that the orbital tumors are extremely malignant, or that they are diagnosed and treated too late.

In 46 patients the orbit was invaded from adjacent structures, mostly the nasal sinuses. This is an unusually high percentage of cases and probably reflects the author's main interest in diseases of the nose and the nasal sinuses. These lesions he calls "secondary" tumors.

Not much issue can be taken with this part of the book. Of course, one can always find a small detail which seems incorrect or with which ophthalmologists would not agree.