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Edited by Richard K. Dortzbach, MD
New York, Raven Press, 1994, $189.00
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The first chapter on orbital and eyelid anatomy is quite educational. The chapter on ectropion is quite informative, but, regretfully, no mention is made of a properly performed canthopexy, in which the orbital septum is freed from the arcus marginalis, the lower lid is vertically and horizontally lengthened, the tilt of the commissure (mongoloid) is exaggerated, and the pseudodermachalasis is redraped [1] . The result of this procedure is much more aesthetic than the lateral tarsal strip, which raises only the lateral aspect of the commissure and causes a horizontal shortening. I recommend the use of hard palate mucosa for the tense posterior lamella, and this seems to be a great adjunct for those who have used it.
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In the management of herniated fat pads, the eventual resorption of fat with aging and the ensuing enophthalmos are not mentioned. Of course, the removal of fat pads can age eyelids prematurely, and this is why more and more plastic surgeons are reluctant to remove them. It is preferable to reduce them with a transconjunctival approach and maintain their reduction by suturing the lower capsulopalpebral fascia flap to the arcus marginalis [2] . A properly performed canthopexy will raise the eyeball via the Lockwood suspensory ligament and increase the space between the eyeball and the orbital floor, thereby somewhat reducing the herniated fat pad.
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The chapter on orbital fractures is well done considering the space available. Most of the chapters are devoted to ophthalmic surgery.
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This well-written textbook eloquently exhibits the vast experience of many qualified ophthalmologists, and the remarkable photography further confirms their experience and expertise. I congratulate the authors.
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André Camirand, MD
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References
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- Camirand A. Canthopexy and transconjunctival blepharoplasty are preferable to lower blepharoplasty.
Can I Plast Surg 19931994 1:184-187
- Camirand A. Reinforcing the orbital septum of the eye through a transconjunctival approach.
Oper Tech Plast Reconstr Surg 1994; 1:160 17
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