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 […]


The Cataract Patient That Also Has “Dry Eye”

By |March 2nd, 2017|Blog, Corneal Transplants, Dry Eye, Duke Eye Center|0 Comments

A striking percentage of patients needing eye surgery, particularly cataract surgery have the signs and symptoms of preexisting “dry eye” consisting of tear film instability, rapid tear breakup time, ocular surface disease – all resulting from inspissated secretions clogging meibomian glands leading to blockage and dysfunction.  The single most effective treatment in my practice involves a pre-treatment preparation of the glandular openings followed by a painless, 12-minute treatment delivering vectored thermal pulsation.  A treatment that I did earlier today is best represented by the attached video of a patient who underwent successful treatment a year ago and now is back […]


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, […]


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 […]


Tearscience Achieves 20,000+ Dry Eye Treatments Using LipiFlow

By |June 30th, 2013|Blog, Dry Eye, Duke Eye Center, LASIK, Refractive Surgery|0 Comments

The LipiView diagnostic instrumentation and LipiFlow Thermal Pulsation Units by TearScience bring an enormous advance for our patients suffering from one of the most common conditions seen in virtually every optometric and ophthalmic practice – including the Duke Eye Center in Durham, NC.  This condition is dry eye and the most common cause resulting in dry eye is tear film instability rather than tear production.  If you asked me 15 years ago about dryness of the ocular surface, I would relate the problem to aging, hormonal changes, and inadequate tear production.  We have witnessed a dramatic shift in our understanding […]


Duke Eye Center Links Obstructive Sleep Apnea to Keratoconus

By |July 5th, 2012|Blog, Corneal Transplants, Duke Eye Center, Keratoconus|0 Comments

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 […]


A Dry Eye Patient Discusses Her Improvement 8-Weeks After LipiFlow Treatment at Duke Eye Center

By |May 23rd, 2012|Blog, Dry Eye, Duke Eye Center, LASIK|0 Comments


LipiFlow is a thermal pulsation treatment produced by TearScience (Morrisville, NC) invented by Dr. Donald Korb (Boston, MA) that received FDA approval in July 2011 established as safe and effective in the treatment of meibomian gland dysfunction (MGD) and its role leading to evaporative dry eye.  This treatment has been available at Duke Eye Center since October 2011 when Duke became the first medical center in the country to offer this treatment on a commercial, non-experimental basis.  Alan N. Carlson, M.D., Professor of Ophthalmology and Chief of the Corneal and Refractive Surgery Service at the Duke Eye Center has found […]


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 […]


Seven Scientific Posters Sponsored by TearScience at ARVO Advance Understanding of Evaporative Dry Eye to Improve Patient Care

By |May 14th, 2012|Blog, Dry Eye, Duke Eye Center, LASIK, Uncategorized|0 Comments

TearScience Inc. announced that it sponsored research for seven scientific posters on evaporative dry eye and its technology at ARVO. Subjects reflect new, ongoing research on the disease, TearScience’s technology, and clinical outcomes. The posters cover topics such as how the LipiFlow Thermal Pulsation System can rejuvenate Meibomian gland secretions for up to a year as well as LipiFlow’s efficacy and safety over warm compress therapy for treating Meibomian gland dysfunction. Another demonstrates LipiView Ocular Surface Interferometer’s ability to consistently and accurately measure the thickness of thin film, optically similar to the tear film. Additional research presented increases the general […]