Sutureless Cataract Surgery: An Evolution Toward Minimally Invasive Technique. Edited by James P. Gills, MD, Robert G. Martin, MD, and Donald R. Sanders, MD. Thorofare, NJ: SLACK Incorporated; 1992.
Sutureless Cataract Surgery is a much-needed, up-to-date book of a timely topic. Edited by three extremely experienced anterior segment surgeons and containing contributions from ten recognized authorities in the field, this book provides an excellent overview of sutureless cataract surgery.
This book is divided into two sections. The first section deals with the topic of the book: sutureless intraocular lens (IOL) surgery. I think this should have carried the same title as the book, since 99% of the discussion deals with cataract wound construction and dynamics (which is the topic of the book), and only 1% of the discussion deals with IOL techniques (which is not the topic of the book). Such trivialities aside, the six chapters in this section provide excellent and comprehensible coverage of all aspects of the self-sealing cataract wound including: the evolution of the technique (Chapters 1-2), engineering aspects of the wound (Chapter 3), advantages and disadvantages of sutureless cataract surgery (Chapter 4), surgical techniques (Chapter 5), and results (Chapter 6).
The strengths of this section include excellent clinical photos and superb data graphs which are elegant and easy to read. The chapter on engineering aspects of the wound is particularly good, containing excellent diagrams and descriptions of the mechanics of different types of cataract wound design. The chapter on techniques presents at least six different surgical variations to introduce the reader to the subtle variations in the sutureless wound techniques. The only potential weakness is the use of data from multiple surgeons (both published and unpublished) within the same areas of discussion to support the authors contentions of the clear superiority of sutureless surgery over small incision/single stitch techniques.
The second section is a "bonus section" on The Management of Preexisting Astigmatism. In the editors' own words, if sutureless cataract surgery eliminates the problem of induced astigmatism, the surgeon may now turn his attention to the elimination of preexisting astigmatism. Two chapters cover corneal relaxing incisions and one chapter is devoted to theoretical advantages of toric IOLs. Dr Gills' presentation on his results of 203 cases of combined relaxing incisions in conjunction with sutureless cataract surgery is particularly impressive.
This book is an excellent addition to the rapidly growing list of publications in the field of smallincision cataract surgery. It is an excellent resource for any anterior segment surgeon who is interested in pursuing these techniques.