Smolin and Thoft's the Cornea: Scientific Foundations and Clinical Practice
http://www.100md.com
《新英格兰医药杂志》
The cornea is the major refractive element of the eye. Its perfect transparency depends on the order of its collagen fibrils and an avascularity determined by intrinsic vasogenic inhibitors. Hydration is regulated by a posterior endothelial layer; dysfunction of this layer results in corneal edema and visual loss. The healing response to injury, so beneficial in other tissues, causes blindness when it leads to corneal scarring. So it is appropriate that The Cornea deals with aspects of physiology and pathophysiology that are critical to an understanding of corneal disease.
This book reviews many areas of current interest, including the use of amniotic membrane and corneal epithelial stem cells in ocular-surface reconstruction and technically challenging surgical procedures such as deep lamellar keratoplasty and posterior lamellar endothelial keratoplasty. There are outstanding chapters on inflammation and infection, common and rare corneal disorders, and various forms of corneal surgery. There is a particularly good section on herpes simplex virus keratitis, including the use of systemic antiviral drugs to prevent recurrent disease. Whether this kind of prophylaxis should prompt surgeons to embark on refractive surgery in patients with a history of herpes simplex virus keratitis is, however, a moot point.
Sight-threatening diseases associated with the collagen vascular disorders or cicatrizing conjunctivitis are described with particular clarity. C. Stephen Foster makes an impassioned plea for early and aggressive systemic immunosuppressive therapy in patients with the ocular signs of collagen vascular disease. He stresses that ocular inflammation is an extremely sensitive predictor of catastrophic extraocular vasculitis, even when systemic disease appears to be in remission, and he observes that "few ophthalmologists and even fewer rheumatologists are aware of this phenomenon." His words encourage close collaboration between ophthalmologists and physicians in the management of these disorders.
Corneal disease contributes to blindness on a world scale. Trachoma and vitamin A deficiency affect 3.5 million people and account for more than 7 percent of the world's blind persons. These and related topics receive adequate attention in the book, although not in proportion to their effects worldwide.
The topic of refractive surgery occupies a quarter of this book, and various chapters describe its technological evolution, including the development of new lasers, flying-spot delivery systems, topographic displays of corneal shape and thickness, eye tracking to ensure topographic registration, and wavefront sensing to determine the higher-order aberrations of the ocular media. One chapter invites us to accept "the ultimate aim of sculpting an optically perfect eye in which the unaided postoperative visual acuity exceeds the preoperative, spectacle corrected visual acuity." Refractive surgery involves the surgical modification of corneal shape for optical or therapeutic purposes, chiefly by laser ablation. Currently, there is vigorous competition between the techniques of surface ablation, such as photorefractive keratectomy (PRK) and laser-assisted in situ keratomileusis (LASIK), in which the internal stroma is ablated after the creation of a superficial flap. PRK has been favored for the military and for those who engage in contact sports, whereas LASIK is popular because it can treat a wider range of refractive errors than can PRK and offers earlier visual rehabilitation with less postoperative pain. But LASIK also carries the risk of flap-related complications. This kind of surgery, relying on a remarkable cooperation between optical scientists, physicists, and surgeons, comes under intense professional scrutiny, and it is reassuring to know that its safety and predictability are reliable and constantly monitored. The book abounds with helpful tips and caveats.
The fourth edition of this book is very different from its predecessors. It is greater in scope and size and has three times as many contributors as the third edition. The quality of the writing reflects the stature of the contributors. There are abundant illustrations, but future editions would benefit from more tables to clarify embedded text, more drawings to illustrate surgical procedures, and more cross-referencing to reduce overlap. Also, a few key, strategically placed colored plates would be more welcome than the large block of plates juxtaposed with the index. Despite these quibbles, this book is an outstanding achievement and will be a welcome resource for residents in training and established specialists for years to come.
Anthony J. Bron, F.R.C.Ophth., F.Med.Sci.
Nuffield Laboratory of Ophthalmology
Oxford OX2 6AW, United Kingdom(Fourth edition. Edited by)
This book reviews many areas of current interest, including the use of amniotic membrane and corneal epithelial stem cells in ocular-surface reconstruction and technically challenging surgical procedures such as deep lamellar keratoplasty and posterior lamellar endothelial keratoplasty. There are outstanding chapters on inflammation and infection, common and rare corneal disorders, and various forms of corneal surgery. There is a particularly good section on herpes simplex virus keratitis, including the use of systemic antiviral drugs to prevent recurrent disease. Whether this kind of prophylaxis should prompt surgeons to embark on refractive surgery in patients with a history of herpes simplex virus keratitis is, however, a moot point.
Sight-threatening diseases associated with the collagen vascular disorders or cicatrizing conjunctivitis are described with particular clarity. C. Stephen Foster makes an impassioned plea for early and aggressive systemic immunosuppressive therapy in patients with the ocular signs of collagen vascular disease. He stresses that ocular inflammation is an extremely sensitive predictor of catastrophic extraocular vasculitis, even when systemic disease appears to be in remission, and he observes that "few ophthalmologists and even fewer rheumatologists are aware of this phenomenon." His words encourage close collaboration between ophthalmologists and physicians in the management of these disorders.
Corneal disease contributes to blindness on a world scale. Trachoma and vitamin A deficiency affect 3.5 million people and account for more than 7 percent of the world's blind persons. These and related topics receive adequate attention in the book, although not in proportion to their effects worldwide.
The topic of refractive surgery occupies a quarter of this book, and various chapters describe its technological evolution, including the development of new lasers, flying-spot delivery systems, topographic displays of corneal shape and thickness, eye tracking to ensure topographic registration, and wavefront sensing to determine the higher-order aberrations of the ocular media. One chapter invites us to accept "the ultimate aim of sculpting an optically perfect eye in which the unaided postoperative visual acuity exceeds the preoperative, spectacle corrected visual acuity." Refractive surgery involves the surgical modification of corneal shape for optical or therapeutic purposes, chiefly by laser ablation. Currently, there is vigorous competition between the techniques of surface ablation, such as photorefractive keratectomy (PRK) and laser-assisted in situ keratomileusis (LASIK), in which the internal stroma is ablated after the creation of a superficial flap. PRK has been favored for the military and for those who engage in contact sports, whereas LASIK is popular because it can treat a wider range of refractive errors than can PRK and offers earlier visual rehabilitation with less postoperative pain. But LASIK also carries the risk of flap-related complications. This kind of surgery, relying on a remarkable cooperation between optical scientists, physicists, and surgeons, comes under intense professional scrutiny, and it is reassuring to know that its safety and predictability are reliable and constantly monitored. The book abounds with helpful tips and caveats.
The fourth edition of this book is very different from its predecessors. It is greater in scope and size and has three times as many contributors as the third edition. The quality of the writing reflects the stature of the contributors. There are abundant illustrations, but future editions would benefit from more tables to clarify embedded text, more drawings to illustrate surgical procedures, and more cross-referencing to reduce overlap. Also, a few key, strategically placed colored plates would be more welcome than the large block of plates juxtaposed with the index. Despite these quibbles, this book is an outstanding achievement and will be a welcome resource for residents in training and established specialists for years to come.
Anthony J. Bron, F.R.C.Ophth., F.Med.Sci.
Nuffield Laboratory of Ophthalmology
Oxford OX2 6AW, United Kingdom(Fourth edition. Edited by)