Duke Eye Center Links Obstructive Sleep Apnea to Keratoconus

Research Digest
New & Noteworthy Journal Articles
Compiled by Andrew E. Mathis, PhD, Medical Editor
► Keratoconus and sleep apnea. Noting the sparseness of post-keratoplasty patients among their elderly patients, ophthalmologists Preeya Gupta, M.D., Assistant Professor of Ophthalmology and Alan N. Carlson, M.D., Professor of Ophthalmology and Chief of the Corneal Service at the Duke Eye Center in Durham, NC, undertook a study to determine whether there was any correlation between keratoconus and mortality, looking specifically at sleep apnea as a primary symptom. They report their findings in the June 2012 issue of Cornea.

The authors conducted telephone interviews with 101 patients diagnosed with […]

Ceremonial Ground-Breaking for New Duke Eye Center Clinical Facility

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
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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 in Patients with Keratoconus

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 […]

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

The Dry Eye Patient 4-Months After LipiFlow Thermal Pulsation Therapy

Early results representing my clinical observations and also the subjective response of several patients after treatment have overall led me to believe that the LipiFlow Thermal Pulsation device from TearScience has been one of the most worthwhile additions to my clinical practice in recent years.  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 subspecializes in cataract surgery, corneal transplantation, and laser vision correction (LASIK) and as studied optimizing surgical outcomes for best practices and recognizes that the treatment of symptomatic dry eye syndromes is […]

Recent Advances is the Surgical Management of Keratoconus

Two of the most significant surgical advances now available for patients suffering from keratoconus who develop contact lens intolerance are Intacs instrastromal corneal ring segments (ICRS) and deep anterior lamellar keratoplasty (DALK) – both provide an alternative to full thickness (or penetrating) keratoplasty or corneal transplantation.  Many folks are going to immediately wonder about corneal collagen cross-linking and I am going to cover that later as “the jury” is still out and as I try to meticulously “connect the dots” of how people develop disease progression, I am less convinced that we will be doing cross-linking 10 years from now.  […]

By |February 16th, 2012|Blog, Corneal Transplantation, Duke Eye Center, Keratoconus|0 Comments

Fuchs’ Corneal Dystrophy, Dense Cataract, Salzmann’s Nodular Degeneration, and Monocular = Needs Fixing

Today’s patient presentation has Fuchs’ Corneal Dystrophy, a visually significant nuclear sclerotic cataract, an elevated Salzmann’s Nodule, and only has one eye.  Each monocular patient, having only one eye, requires special consideration in preparation for eye surgery in terms of surgical options, timing, limitations, benefits, risk analysis, emotional support, postoperative care, and also the process of informed choice and consent.  I feel fortunate to have operated on over 500 patients considered “monocular” and consider it a privilege to be able to walk these patients through the additional education and decision-making process that is required.  My dear patient who has lost […]

Corneal Transplantation (Keratoplasty) Using the DSAEK Technique in the Multitube Hypotonous Glaucoma Patient

Glaucoma, previous filtering tube surgery, and hypotony are ALL risk factors for DSAEK surgery and increase the risk of donor tissue detachment.  Alan N. Carlson, M.D., Professor of Ophthalmology and Chief of the Corneal and Refractive Surgery Service at the Duke Eye Center demonstrates the techniques behind successful corneal transplantation using the DSAEK (Descemets Stripping Automated Endothelial Keratoplasty  technique that ultimately required transcorneal sutures to secure the donor tissue.  THis particular patient had low intraocular pressure and repeated detachments eventually needing sutures to accomplish success!

When is Corneal Transplantation Considered “High Risk?”

Remarkably, corneal transplantation is considered one of the most successful of all transplanted organs.  There are a number of factors contributing to this.  We used to think that it was protected from immune recognition due to the lack of blood vessels.  More recently, we have a better understanding that the eye along with the CSF (cerebral spinal fluid) and blood stream constitute the 3 most rapid methods of antigen or “foreign” matter detection and we have revised our thinking with respect to Corneal Transplantation as a precess of antigen “tolerance” rather than lack of recognition.  There are certain things that […]

By |January 3rd, 2012|Blog, Corneal Transplantation, Duke Eye Center, Keratoconus|0 Comments

“Dr. Carlson, I am afraid of eye surgery. I only have one eye.”

Each monocular patient, having only one eye, requires special consideration in preparation for eye surgery in terms of surgical options, timing, limitations, benefits, risk analysis, emotional support, postoperative care, and also the process of informed choice and consent.  I feel fortunate to have operated on over 500 patients considered “monocular” and consider it a privilege to be able to walk these patients through the additional education and decision-making process that is required.  Today’s case is a University Professor who has lost vision in her only useful eye due to a cataract and also Fuchs’ Corneal Dystrophy.   Cataract surgery alone […]

Combining Cataract Surgery with Corneal Transplantation

Endothelial Keratoplasty has largely replaced penetrating keratoplasty for patients with Fuchs’ Corneal Dystrophy or other causes of endothelial dysfunction and failure.  This is confirmed reviewing our past 1600 DSEK / DSAEK procedures performed at the Duke Eye Center in Durham, NC according to Alan N. Carlson, M.D., Professor of Ophthalmology and Chief of the Corneal and Refractive Surgery Service at Duke.  Today’s video demonstrates Dr. Carlson performing cataract surgery in combination with corneal transplantation often called the DSAEK “Triple.”  The specimen placed on the cornea includes the thickened posterior collagenous layer along with Descemet’s membrane and the dysfunctional dystrophic endothelium […]