primary malignant melanoma of the skin metastatic to the eye and orbit
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794 AMERICAN JOURNAL OF OPHTHALMOLOGY OCTOBER, 1967
agree with the premise on which the conclusion is based. Preoperative antibiotics eliminate the easily destroyed bacteria from the external eye and allow the resistant bacteria to multiply and enter the internal eye at time of surgery.
Perhaps a co-operative study, performed over a five to 10-year period, by Dr. Allen's group, ours and several other institutions, would be of value. Such a study should utilize alternate cases to be treated with either topical or subconjunctival antibiotics.
Allen E. Kolker Saint Louis, Missouri
IRIDOCYCLECTOMY FOR BENIGN TUMORS OF THE CILIARY BODY
Editor,
American Journal of Ophthalmology : In their article which appeared in the
March issue (Am. J. Ophth. 63:447, 1967) Peter G. Burch and A. Edward Maumenee are quoting among other reports an article previoulsy published in T H E JOURNAL (Bor-ley, W. E., and Miller, W. W. : Iridocyclectomy, a technique for removal of iris melanomas. Am. J. Ophth. 60:829, 1965). This quoted report had after its appearance induced me to write a letter to the editor (Am. J. Ophth. 61:572, 1966). In it I reported a very similar method practised by A. Elschnig and described by me more than 50 years ago (Raubitschek, E. : Ueber Iris-tumoren. Klin. Mbl. Augenh. 53:684, 1914.) The similarities as well as the differences of the methods were exposed in my letter of 1966.
Albeit my letter encountered a vivid interest on the part of the ancient authors, leading to a personal correspondence between one of them and myself, it failed apparently to attract the attention of recent authors who, otherwise, would probably be interested in it as would their readers.
E. Raubitschek Baghdad, Iraq
REPLY TO DR. RAUBITSCHEK
Editor, American Journal of Ophthalmology :
Our apologies to^Dr. Raubitschek whose previous letter to the editor appeared shortly before our manuscript was submitted for publication. As he correctly points out, the surgical procedure of combined excision of a portion of the iris and ciliary body was performed by Prof. Elschnig more than a half century ago
The three cases described by Dr. Raubitschek differ from ours in that all had tumors confined to the iris. In two of these, a portion of the ciliary body was removed in addition to the iridectomy, presumably to insure excision of the entire tumor with a surrounding margin of normal tissue. The tumors in all of our cases involved the ciliary body and, therefore, a meridional scierai incision extending posteriorly from the lim-bal incision was required to expose and excise these lesions.
Peter G. Burch Baltimore, Maryland
PRIMARY MALIGNANT MELANOMA OF THE SKIN METASTATIC TO THE EYE AND ORBIT
Editor, American Journal of Ophthalmology :
I regret very much that my coauthors and I failed to acknowledge the source of the only clinical picture we used in reporting our series of 10 cases of metastatic malignant melanoma to the eye and orbit (Am. J. Ophth. 63:738, 1967). If possible, I would appreciate you publishing a note in T H E JOURNAL indicating our gratitude to Dr. R. James Hooper of Macon, Georgia, who provided us with the Kodachrome slide from which our Figure 12 was prepared and who also obtained the anterior-chamber fluid in which the neoplastic cells shown in our Figure 13 were identified.
Lorenz E. Zimmerman Washington, D.C.