Oculoplastic Surgery, 3rd edn

Review by G Ullas
Newcastle upon Tyne, UK

Oculoplastic surgery is an increasingly popular specialty of ophthalmology, with most such departments now having a specialist in this field. It is also increasingly popular among their trainees. This specialty works in the orbit, eyelids and lacrimal system. This includes working with endoscopes and even performing endoscopic dacryocystorhinostomy procedures. Mr Leatherbarrow is a name that needs no introduction in oculoplastic circles. With 25 years’ experience in the field, Mr Leatherbarrow is truly an expert, and he has contributed to the increasing popularity of oculoplastics in the UK. He also provides an interesting perspective, having been trained both in the UK and USA, combining the best of both worlds. Oculoplastic surgery has an appreciable overlap with facial plastic surgery, an emerging subspecialty of ENT. Facial plastic surgery, while under-represented in the UK, is growing, and is very much involved in surgery of the eyelid, brow and upper face. Therefore, this book is relevant to our readership.

‘Comprehensive’ is likely the best single word to describe this book. It is thorough in its approach to every chapter. It is particularly helpful, as it starts from the basics of surgical principles and anatomy, even going down to the level of preferred sutures, with text advising of the relative benefits. There is even a section covering local flap creation and use. These sections on basic surgical principles are often overlooked, but are relevant no matter what stage of practice an individual occupies. This attention further adds to the comprehensive nature of this text.

Looking further into the book, there is an excellent chapter on socket surgery that covers topics of interest to head and neck surgery colleagues. This includes orbital exenteration. The operative technique is described in an easy to follow manner, backed up by photographs. In addition, a range of post-exenteration reconstructive options are described, to account for differences in patient factors.

For readers interested in expanding their practice to include aesthetic surgery, there is a section on cosmetic surgery. As with the rest of the text, it is very detailed. I will draw particular attention to the assessment of the aesthetic patient and the chapter on the complications of blepharoplasty. Assessment of patients seeking aesthetic procedures is, without a doubt, difficult, and many surgeons have been ‘burned’ by this. While there is no fail-safe method, the structure provided here is most helpful. Furthermore, all procedures in medicine have potential complications. Failure to recognise these complications leads to more issues; hence, I found the section on the complications very useful.

ENT surgeons interested in reconstructive eyelid surgery will also find the extensive section on the subject to be of value. This addresses everything from lower eyelid ectropion (common in facial nerve palsy patients) to skin cancer. The eyelids are a challenging area to reconstruct, but this book explains the approaches and options very well, including detailed descriptions.

In conclusion, this book is essentially ‘the Scott-Brown of oculoplastics’, as a comprehensive and thorough text covering all aspects of oculoplastic surgery. It is therefore highly impressive that Mr Leatherbarrow wrote this text by himself! As a trainee pursuing facial plastic surgery as a career, this is a must-have for my personal library. One aspect that stood out for me was the potential for the described transcaruncular approach for accessing the medial orbital wall. This raises a possibility of treating peri-orbital abscesses without the need for the visible scar left by the Lynch–Howarth incision. Overall, I recommend this book to any reader interested in facial plastic surgery or eyelid surgery, although there is something to interest almost any ENT surgeon.

Amazon Link: Oculoplastic Surgery, 3rd edn
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