Sutureless PDEK Triple Procedure

By |July 15th, 2017|Cataracts, Corneal Transplants, Duke Eye Center|0 Comments

Corneal Transplantation has undergone several advances over the past 2 decades.  From full thickness penetrating keratoplasty (PK) to Deep Lamellar Endothelial Keratoplasty (DLEK – Dr. Mark Terry), Descemet’s Membrane Endothelial Keratoplasty (DSEK – Drs. Garrett Melles and Frank Price), DSAEK (“A” for Automated – Dr. Mark Gorovoy), Descemet’s Membrane Endothelial Keratoplasty (DMEK – Drs. Garrett Melles and Frank Price) and now, Pre-descemet’s Endothelial Keratoplasty (PDEK – Dr. Amar Agarwal).


Potential advantages of PDEK, this latest version of endothelial keratoplasty include:

a) ability to use younger donor tissue in comparison to DMEK

b) a more predictable learning curve and procedure (my opinion) over DMEK

c) […]


Are you anxious about cataract surgery?

By |March 5th, 2017|Astigmatism, Blog, Cataracts, Duke Eye Center, Myopia, Refractive Surgery|0 Comments

Cataract surgery, understandably causes anxiety to anyone needing or considering this procedure.  Patients hear “there is nothing to it” but every patient knows that there are potential problems.  If there were not potential problems, they would not need to undergo and sign an “informed consent.”  My patient offers a HIPAA-compliant and Social Media-compliant in-depth analysis of her care at Duke Eye Center in Durham, NC.  In her case, we addressed her pre-existing retinal surgery, high degree of myopia and astigmatism, and her anxiety.  This involved the Femtosecond LenSx LASER, Verion precision, ORA intraoperative wavefront aberommetry confirmation, and a premium toric […]


Needle Driver Designed to Make Eye Surgery More Precise and Efficient

By |February 16th, 2017|Cataracts, Corneal Transplants, Duke Eye Center, Uncategorized|0 Comments

While much of our surgery in Ophthalmology has moved away from needing sutures, there are still procedures that require very delicate suturing, including corneal transplant procedures, deep anterior lamellar keratoplasty, traumatic injuries, sutured intraocular lens implants, and other procedures.  I am grateful to Doug Mastel and the great folks at John Weiss & Son International for their help in bringing into production the Carlson-Troutman needle holder that serves as an extremely precise needle driver while simultaneously serving as a tying forcep – allowing the passage of a needle and also tying the suture without exchanging instrumentation – improving efficiency, precision, […]


Why a lens is called a lens?

By |February 16th, 2017|Blog, Cataracts|0 Comments

What is a lens?  A lens is a transmissive optical device that focuses or disperses a light beam by means of refraction. A simple lens consists of a single piece of transparent material, while a compound lens consists of several simple lenses (elements), usually arranged along a common axis.

Lenses are made from materials such as glass or plastic and ground and polished or molded to a desired shape. A lens can focus light to form an image unlike a prism, which refracts light without focusing. Devices that similarly focus or disperse radiation oth
er than visible light are also called lenses, […]


Panuveitis Treated with Cataract Surgery, Intraocular Lens Insertion, Synechialysis, Retisert Steroid Implant, and Glaucoma Filtration Tube

By |August 12th, 2016|Blog, Cataracts, Duke Eye Center, Glaucoma, Retina, Uncategorized|0 Comments


Panuveitis can be one of the most challenging problems in Ophthalmic Surgery as this type of severe and pervasive inflammation can affect multiple aspects of the eye resulting in loss of vision.  This particular patient needs the Retisert steroid implant for the treatment of severe inflammatory complications.  Alan N. Carlson, M.D., Professor of Ophthalmology and Chief of the Corneal and Refractive Surgery Service at the Duke Eye Center in Durham, NC works closely with Glenn Jaffe, MD and Pratap Challa MD to treat this patient with removal of scar tissue (synechialysis and removal of pupillary membrane), cataract removal, intraocular lens […]


Leading Eye Surgeons Gather to Teach the 8th Annual Harvard Cataract Course

By |May 22nd, 2012|Cataracts, Duke Eye Center|0 Comments

Leading eye surgeons selected by their peers as best teachers / surgeons from 28 Universities gathered to teach the 8th Annual Harvard Cataract Course under course directors Roberto Pineda II, M.D. and Sherleen Chen, M.D from Mass Eye and Ear Infirmary.  The course, given over two days included Dr. Natalie Afshari, Professor of Ophthalmology at Duke Eye Center addressing the importance of intraocular lens calculations.  Dr.  Barry Seibel lectured on Phaco settings and Fluidics and Dr. Bob Avery gave a meticulous discussion on Phaco Chop techniques.  Alan N. Carlson, M.D., Professor of Ophthalmology and Chief of the Corneal and Refractive […]


Pupillary Circlage: Repairing the Permanently Dilated Traumatic Pupil During Cataract Surgery

By |April 30th, 2012|Blog, Cataracts, Duke Eye Center, Glaucoma|0 Comments

There are a number of potential injuries that can occur to the eye producing the permanently dilated pupil.  Infection, angle closure glaucoma, previous surgery, and blunt trauma can all produce this problem.  The permanently dilated pupil is more likely to produce unwanted glare, brightness during the day, and halos around oncoming headlights.  This functional impact may also include a cosmetic problem as well in patients that have a light colored iris  making the problem of anisocoria more apparent. Alan N. Carlson, M.D., Professor of Ophthalmology and Chief of the Corneal and Refractive Surgery Service at the Duke Eye Center in […]


Ceremonial Ground-Breaking for New Duke Eye Center Clinical Facility

By |April 20th, 2012|Blog, Cataracts, Corneal Transplants, Dry Eye, Duke Eye Center, Glaucoma, Keratoconus, LASIK, Myopia, Refractive Surgery, Retina|0 Comments

Thanks to Bill and Kathy Hudson and LC Industries for their generosity toward the new state-of-the-art clinical Duke Eye Center in Durham, NC. 

From: Victor J. Dzau, M.D., Chancellor for Health Affairs; CEO, DUHS

Subject: Ceremonial Ground-Breaking for New Eye Center Clinical Facility

This morning we held a ground-breaking ceremony for a new, state-of-the-art Duke Eye Center building that will add much-needed clinical examination space and enhance the patient experience.

The ceremony celebrated the team effort that has turned this dream of building a new Eye Center clinical facility into a reality. Thanks to the collaborative efforts of our legion of generous donors, […]


Cataract Surgery Pearls for Treating the Patient with Small, Poorly Dilating Pupils

By |March 18th, 2012|Blog, Cataracts, Duke Eye Center|0 Comments

Alan N. Carlson, M.D., Professor of Ophthalmology and Chief of the Corneal and Refractive Surgery Service at the Duke Eye Center was asked by Cataract and Refractive Surgery Today to review and edit the surgical “pearls” used for successful cataract surgery in patients with small, poorly dilating pupils.  Patients undergoing cataract surgery with small pupils pose additional risk for potential complications.  It is important to establish prior to surgery the ability to dilate the patient and factors that may hinder dilation.  Identifying predisposing factors such as tamusolin (Flomax) usage or the condition of pseudoexfoliation is particularly important.  Intraoperative “epi-Shugarcaine” is […]


Cataract Surgery in Patients with Keratoconus

By |March 5th, 2012|Blog, Cataracts, Duke Eye Center, Keratoconus|0 Comments

Keratoconus (KC) patients frequently seek the benefits of Intacs Intracorneal Ring Segments (ICRS) as these devices improve the corneal curvature (topography) and also in many patients remarkably slows down the progression of KC, making corneal transplantation less likely.  Alan N. Carlson, M.D., Professor of Ophthalmology and Chief of the Corneal and Refractive Surgery Services at the Duke Eye Center in Durham, North Carolina sees a large number of patients with Keratoconus from Raleigh and Durham and Chapel Hill and has wondered if Keratoconus may be more prevalent in North Carolina in comparison to other regions.  One question that always comes […]