Frederick T. Fraunfelder

NO-TOUCH CRYOSURGICAL ENUCLEATION: A MINIMAL TRAUMA TECHNIQUE FOR EYES HARBORING INTRAOCULAR MALIGNANCY

Current surgical approaches for cancer are emphasizing minimal trauma--the so-called no-touch technique of tumor removal. Tumor seeding through the circulatory system seems reasonable, particularly with friable and necrotic tumors. Attempts to reduce metastatic seeds should originate with the original procedure. Enucleation of nontumor eyes with simultaneous intraocular manometry has shown which surgical maneuvers elevate intraocular pressure and how ocular massage can be avoided. Our surgical procedure involves a delicate surgical technique coupled with transscleral cryocoagulation to immobilize the tumors blood supply.

What can we learn from the visual care system of the British National Health Service

The development of the British National Health Service over the past three decades is described, with particular emphasis on delivery of eye care. Differences between the British and American systems are discussed with consideration of the general political, philosophical and socioeconomic conditions of both countries.