Power List Is Is the Future of Retinal Repairing RK: CXL Pioneer, Gloriously Subjective Implants Organic? a New Carpet on Broken Tiles Farhad Hafezi

APRIL 2017 # 40

Editorial Upfront In Practice Sitting Down With Why the Power List is Is the future of retinal Repairing RK: CXL pioneer, gloriously subjective implants organic? a new carpet on broken tiles Farhad Hafezi

07 08 62 – 65 66

Power List 2017

Meet the Top 50 “Rising Stars” shaping the future of ophthalmology 14 – 57

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INDICATIONS AND IMPORTANT SAFETY INFORMATION FOR THE TECNIS SYMFONY® AND TECNIS SYMFONY® TORIC EXTENDED RANGE OF VISION IOLs Rx Only INDICATIONS: The TECNIS Symƒony® Extended Range of Vision IOL, model ZXR00, is indicated for primary implantation for the visual correction of aphakia, in Preparing to Make History adult patients with less than 1 diopter of pre-existing corneal astigmatism, in whom a cataractous lens has been removed. The lens mitigates the effects of presbyopia by providing an extended depth of focus. Compared to an aspheric monofocal IOL, the lens provides improved intermediate and near visual acuity, while maintaining comparable distance visual acuity. The model ZXR00 IOL is intended for capsular bag placement only. The TECNIS Symƒony® Toric Extended Range of Vision IOLs, Robert MacLaren and his team prepare to perform the first ever subretinal injection of AAV-XLRPGR models ZXT150, ZXT225, ZXT300, and ZXT375, are indicated for primary implantation for the visual correction of aphakia and for reduction of residual refractive gene therapy into a patient with retinitis pigmentosa. astigmatism in adult patients with greater than or equal to 1 diopter of preoperative corneal astigmatism, in whom a cataractous lens has been removed. The lens mitigates the effects of presbyopia by providing an extended depth of focus. Compared to an aspheric monofocal IOL, the lens provides improved intermediate and near visual acuity, while maintaining comparable distance visual acuity. The model series ZXT IOLs are intended for capsular bag placement only.WARNINGS: May cause a reduction Image credit: University of Oxford. in contrast sensitivity under certain conditions, compared to an aspheric monofocal IOL. Inform patients to exercise special caution when driving at night or in poor visibility conditions. Some visual effects may be expected due to the lens design, including: perception of halos, glare, or starbursts around lights under nighttime conditions. These will be bothersome or very bothersome in some people, particularly in low-illumination conditions, and on rare occasions, may be significant enough Do you have an image you’d like to see featured in The Ophthalmologist? that the patient may request removal of the IOL. Rotation of the TECNIS Symƒony® Toric IOLs away from their intended axis can reduce their astigmatic correction, and misalignment greater than 30° may increase postoperative refractive cylinder. If necessary, lens repositioning should occur as early as possible prior to lens Contact [email protected] encapsulation. ATTENTION: Reference the Directions for Use for a complete listing of Indications and Important Safety Information. TECNIS and TECNIS SYMFONY are trademarks owned by or licensed to Abbott Laboratories, its subsidiaries or affiliates. © 2017 Abbott Medical Optics Inc. | www.Vision.Abbott | PP2017CT0185 www.theophthalmologist.com Contents ISSUE 40 - APRIL 2017

Editor - Mark Hillen [email protected] Associate Editor - Roisin McGuigan [email protected] Associate Editor - Ruth Steer Upfront [email protected] Editorial Director - Fedra Pavlou [email protected] 08 Retinal Prostheses: Content Director - Rich Whitworth The Next Generation [email protected] Publishing Director - Neil Hanley [email protected] 09 Business in Brief Sales Manager - Abigail Mackrill [email protected] Head of Design - Marc Bird START 10 A Serious Breach of Trust [email protected] Designer - Emily Strefford-Johnson [email protected] 12 When Multiple Punctures Junior Designer - Hannah Ennis Don’t Deflate [email protected] Digital Team Lead - David Roberts [email protected] HERE Digital Producer Web/Email - Peter Bartley [email protected] Digital Producer Web/App - Abygail Bradley Feature [email protected] Digital Content Assistant - Lauren Torr [email protected] 14 The Power List: Rising Stars Audience Insight Manager - Tracey Nicholls The 2017 Power List has arrived! [email protected] 14 Traffic and Audience Associate - Lindsey Vickers We asked you to name the up- [email protected] and-coming ophthalmologists Traffic and Audience Associate - Jody Fryett shaping the future of the field, [email protected] Social Media / Analytics Associate - Ben Holah and here, we present the results. [email protected] Events and Office Administrator - Alice Daniels-Wright [email protected] Financial Controller - Phil Dale [email protected] In Practice Chief Executive Officer - Andy Davies [email protected] Chief Operating Officer - Tracey Peers 62 N ew Carpet on Broken Tiles [email protected]

Radial Keratotomy was “big” in Change of address the 1980s – but over time, the [email protected] 66 Tracey Nicholls, The Ophthalmologist, Texere drawbacks became apparent: Publishing Limited, Haig House, Haig Road, scarring and myopic shifts. Knutsford, Cheshire, WA16 8DX, UK. Arun Gulani says: don’t be Single copy sales £15 (plus postage, cost available on request [email protected]) disheartened by the scars – ® Annual subscription for non-qualified recipients £110. Choose iStent —First and foremost. good vision for your patients is General enquiries: 03 Image of The Month still possible. www.texerepublishing.com [email protected] Right from the beginning, iStent is designed to restore and maintain conventional physiological +44 (0) 1565 745 200 [email protected] outflow, and deliver a favorable benefit-to-risk ratio. Studied extensively around the world, iStent has 07 Editorial Distribution: been implanted in hundreds of thousands of eyes, and is backed by years of documented efficacy and From Peer to Peer The Ophthalmologist (ISSN 2051-4093) Sitting Down With is published monthly except July, by Texere safety data in reducing intraocular pressure. For patients who have primary open-angle glaucoma, by Mark Hillen Publishing Ltd and is distributed in the USA 66 Farhad Hafezi, Professor, by UKP Worldwide, 1637 Stelton Road B2, pseudoexfoliative glaucoma or pigmentary glaucoma, who might also have cataracts—start with the Piscataway, NJ 08854. University of Geneva; Clinical Periodicals Postage Paid at Piscataway, MIGS leader and finish with leading performance. On The Cover Professor of Ophthalmology, Keck NJ and additional mailing offices POSTMASTER: Send US address changes to APRIL 2017 # 09 School of Medicine, University of The Ophthalmologist, Texere Publishing Ltd,

Upfront In My View In Practice Sitting Down With Is the future of retinal How to free yourself Using OCT for treatment Guillermo Rocha, implants organic? from third parties decisions in glaucoma President of COS

10 14 38 – 42 46 – 49 The Power List gets a Southern California (USC) Los c/o 1637 Stelton Road B2, Piscataway NJ 08854

Power List 2017 Reprints & Permissions – [email protected]

Meet the “Rising Stars” Mondrian Makeover + shaping the future Angeles, USA; Chief Medical of ophthalmology 24 – 43 The opinions presented within this publication are those of the Officer, The ELZA Institute, authors and do not reflect the opinions of The Ophthalmologist or The complete procedure. NORTH AMERICA www.theophthalmologist.com its publishers, Texere Publishing. Authors are required to disclose ASCRS Booth 847 Glaukos.com Zurich, Switzerland. any relevant financial arrangements, which are presented at the end of each article, where relevant. ©2017 Glaukos Corporation. Glaukos and iStent are registered trademarks of Glaukos Corporation. 410-0403-2017-EUR Rev. 1 START HERE

Choose iStent®—First and foremost. Right from the beginning, iStent is designed to restore and maintain conventional physiological outflow, and deliver a favorable benefit-to-risk ratio. Studied extensively around the world, iStent has been implanted in hundreds of thousands of eyes, and is backed by years of documented efficacy and safety data in reducing intraocular pressure. For patients who have primary open-angle glaucoma, pseudoexfoliative glaucoma or pigmentary glaucoma, who might also have cataracts—start with the MIGS leader and finish with leading performance. + The complete procedure. ASCRS Booth 847 Glaukos.com

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The Ophthalmologist K5M Jenvis Dry Eye Masterpiece 210x266 e 4c 03.17.indd 1 17.03.2017 17:07:23 From Peer to Peer Editorial The Power List is gloriously subjective. Why? A Masterpiece of Because it’s ophthalmologists who do the voting! Dry Eye Diagnostics ow do you define a rising star in ophthalmology? It’s not easy. Two years ago, we used the cut-off of 40 years and under. The quality of our cadre was Hthe highest – but had we made the age limit too low? Was it fair on people who really were only just establishing themselves in their own right as an ophthalmologist of renown, after years of training? I had to draw the line somewhere – but was it in the right place? This year, we’ve drawn the line in a different place (page 14) – and it’s no longer the “Top 40 Under 40.” We’ve changed the name to better reflect our initial intention: “Rising Stars.” I know some of you dislike “Top Doctor” lists – Harry Quigley says as much in his In My View article in last month’s issue (1). But this is no such thing. It is not a public popularity contest. I view the Power Lists as an opportunity for peers to let other peers know that they respect them and their work. And though it’s true that the list is subjective – isn’t that the glorious part, given that the people voting are almost entirely ophthalmologists? I do recognize that such lists rarely recognize the people on the front line, working way beyond their contracted hours to clear a clinic or complete that day’s list. But this magazine is your magazine. If that’s the situation you face, day in and day out, talk to us. These issues need to be raised, and if you work with us to tell those stories, they’ll get a good airing. The Power Lists are all about celebrating effort and achievement. I’m very fortunate as Editor of The Ophthalmologist to be able to talk to the big names featured, and when I ask them how they got to where they are, nine times out of 10, they tell me, “I was in the right place at the right time.” But let’s not be under any illusions: they’ve worked incredibly hard to get there too. That deserves an immense amount of respect. Kudos to them. Of course, many of the rising stars of today will become Reference the leading lights of the future. And the future of eyecare 1. H Quigley, “How good a doctor are you?”, is one where aging baby boomers are presenting en masse The Ophthalmologist, 39, 14–15 (2017). with age-related eye disease – many clinics are already full OCULUS Keratograph 5M with JENVIS Dry Eye Report: Available at: top.txp.to/issues/0317/301 to bursting point. But I see the research that these rising stars are performing – and it looks like much of it should be See all relevant dry eye information at a glance! game-changing. So we’re celebrating these ophthalmologists’ achievements today, but if their work pays off, I really hope The JENVIS Dry Eye Report is a unique feature of the OCULUS Keratograph 5M that summarizes all data we’re going to be celebrating them with far more gusto in a from your dry eye workup and offers an easy-to-grasp printout for your patient. Optimize your dry decade or so. eye diagnosis: combine screening and patient education with the OCULUS JENVIS Dry Eye Report!

For more information visit www.dryeyemasterpiece.de Mark Hillen Editor www.oculus.de www.theophthalmologist.com Follow us!

The Ophthalmologist K5M Jenvis Dry Eye Masterpiece 210x266 e 4c 03.17.indd 1 17.03.2017 17:07:23 8 Upfront

and silicon-free, it’s composed of a passive, Retinal silk fibroin substrate, a central conductive Upfront layer of poly (3,4-ethylene-dioxythiopene)- Prostheses: The poly(styrenesulfonate) – PEDOT:PSS for Reporting on the short, and a superficial semiconductive Next Generation layer of poly(3-hexylthiophene) – P3HT. innovations in medicine In the past (2), it’s been shown that glass and surgery, the research Two approaches that could slides coated with P3HT can photoactivate policies and personalities result in a better retinal implant neurons grown on the slide, and when that shape the practice implanted into rats with light-induced Fusing the latest technology with human photoreceptor degeneration, it can restore of ophthalmology. biology to bring sight to the blind, retinal light sensitivity – all without requiring a prostheses capture the imagination. power supply or any external components. We welcome suggestions And though multiple devices are now This flexible silk-based iteration gets rid on anything that’s on the market, they’re still not perfect. of the glass – and possibly the soft tissue Complicated to make and challenging to damage and degradation issues of current impactful on implant, some require an external camera retinal prosthesis designs. They turned to ophthalmology; to function. Most require trans-ocular Royal College of Surgeons (RCS) rats, please email edit@ cables for power or data transfer (which a widely recognized model of retinitis theophthalmologist.com risk damaging the soft tissue of the retina pigmentosa, to test the design – and their every time the eye moves) and there have experimental approach and assessments are been concerns about the longevity of such depicted in Figure 1. electrical components placed in distinctly At 30 days post implantation (DPI), they wet biological tissues. Finally, patients found that, at illuminances of ≥4 lux, their achieve visual acuities of less than 20/200, prosthesis rescued the pupillary reflex, and so they are still legally blind. Can things that prosthesis-induced visually evoked be improved? potentials (VEPs) could be detected in Maya-Vetencourt et al. (1) report the the primary visual (V1) cortex in a manner development of a fully organic retinal that topographically represented the prosthesis that might fit the bill. Metal light-dependent activation of the inner

Figure 1. The assessments performed by Maya-Vetencourt et al (1) to assess the function of a fully organic retinal prosthesis implanted in RCS rats. DPI, days post implantation; OCT, optical coherence tomography; PET, positron emission tomography; RCS, Royal College of Surgeons; SLO, scanning laser ophthalmoscopy; VEP, visual evoked potential. Upfront 9

was associated with increased basal the researchers performed in vitro activity in V1 cortex. Clearly it’s working, electrophysiological experiments on the but the question is how? The authors don’t retinae from rhodopsin P23H knock-in rats actually know: “the detailed principle (a model of retinitis pigmentosa-like retinal of operation of the prosthesis remains degeneration). And they were encouraged uncertain.” by what they found: the horizontal and Meanwhile, engineers at the University of bipolar neurons in the retina fired action California San Diego and the La Jolla-based potentials preferentially when the prosthesis startup, Nanovision Biosciences Inc. have was exposed to a combination of light and taken a different approach: optoelectronic electrical potential – and were silent when Figure 2. Primary cortical neurons cultured on silicon nanowires (Figure 2) that can both either light or electrical bias was absent. In the surface of an optoelectronic nanowire array. sense light and stimulate the retina (3). other words, they showed that the nanowire They’re powered by a wireless inductive array successfully responds to light and retina circuitry harboring the prosthesis. system that transfers energy with up to electrical stimulation. Animal tests with A number of light stimulation paradigms 90 percent efficiency, and also allows both the device are in progress, with clinical paired with V1 VEP measurements were data transfer and control over stimulation trials set to follow. MH performed to assess the recovery of visual paradigms. One of the engineers involved in cortical response and spatial resolution, and the project, Gert Cauwenberghs, noted, “To References visually-driven behavior was assessed using restore functional vision, it is critical that 1. F Maya-Vetencourt et al., “A fully organic the light-dark box test. The organic retinal the neural interface matches the resolution retinal prosthesis restores vision in a rat model prosthesis performed significantly better and sensitivity of the human retina.” They of degenerative blindness”, Nat Mater, [Epub than sham- and non-implanted RCS rat might be on the right track – the tiny size of ahead of print] (2017). PMID: 28250420. controls – and the prosthesis-dependent the nanowires more closely match the dense 2. D Ghezzi et al., “A hybrid bioorganic interface recovery of visual function persisted spacing of photoreceptors in the human for neuronal photoactivation”, Nat Commun, up to 6–10 months after surgery (when retina than the 60 and 1500 electrodes 25, 166 (2011). PMID: 21266966. the rats were sacrificed for histological present in the Second Sight Argus II and 3. S Ha et al., “Towards high-resolution retinal analysis). Further, positron emission Retina Implant Alpha IMP prostheses, prostheses with direct optical addressing and tomography neuroimaging showed that respectively. But can it work? inductive telemetry”, J Neural Eng, 13, the prosthesis’ rescue of visual function To provide proof of concept, 056008 (2016). PMID: 27529371.

programs targeting eye disease. The • Bill Ackman has announced that Business in Brief first could be a lead candidate for Pershing Square Capital Leber Congenital Amaurosis Management has sold all shares in Allergan and Editas join (LCA10) that is currently in the Valeant, and says that he is “deeply forces, Carl Zeiss win a patent preclinical stage but predicted to and profoundly” sorry for his infringement case, and more… enter the clinic later this year. investment in Valeant, writing in a • Carl Zeiss Meditec has won a letter “Clearly, our investment in • Pharmaceutical giant Allergan has patent infringement suit Valeant was a huge mistake. We entered into an R&D agreement concerning its aphakic trifocal deeply regret this mistake, which with new kid on the block and lens. A court in Dusseldorf has cost all of us a tremendous CRISPR specialist Editas ruled that a lens produced by VSY amount, and which has damaged Medicine to discover and develop Biotechnology BV and Fritz Ruck the record of success of our firm.” therapies based on genome-editing Ophthalmologische Systeme • Meanwhile, Valeant’s former for ocular diseases. Editas will GmbH infringed upon the CEO, Michael Pearson, is suing receive $90 million upfront while patent held by Zeiss, and ordered the company, claiming that it Allergan will be able to license up that all of VSY’s trifocal lenses be failed to pay him three million to five candidate recalled and destroyed. shares as part of his exit package.

www.theophthalmologist.com 10 Upfront

Thomas Albini, ophthalmologist at Bascom Palmer Eye Institute, Miami, Florida (2, 3): “In this case, these women participated in a clinical enterprise that was off-the- charts dangerous [...] I knew that things like this could happen in other countries that don’t have a sophisticated medical regulatory environment. But I really was naïve to the fact that this could happen in the United States. Then I realized I was just as naïve about it as the patients were.”

George Daley, leading stem cell biologist and Dean of Harvard Medical School, Boston, Massachusetts (4): Daley wrote that there was a “stark distinction between innovative and/or proliferation of the “stem treatments that are founded on A Serious cells” into myofibroblasts might have methodical preclinical evidence” and “the been responsible. unproven interventions that are offered Breach of Trust The events have opened a regulatory by practitioners who are naïve regarding ‘can of worms,’ raising concerns about the the biological complexities of stem cells How did people react to the oversight and regulation of innovative or by charlatans peddling the modern news that an unapproved therapies. The report brought three day equivalent of snake oil.” He added stem cell therapy blinded disturbing points to light: that it represents a “gross violation of three patients? professional and possibly legal standards.” i. the study was listed on The recent news that three female ClinicalTrials.gov (NCT02024269) Stephen Rose, Chief Research Officer patients suffered vision loss after receiving ii. at least one of the patients believed at Foundation Fighting Blindness, an unproven stem cell therapy for age- they were participating in a clinical Columbia, Maryland (5): related macular degeneration (AMD) trial for AMD “What’s important for the public to has shocked clinicians, scientists and the iii. the women each paid $5,000 to know is that the [ClinicalTrials.gov] public alike. receive the experimental treatment. website listing does not mean that Published in the New England Journal the procedure is approved by NIH of Medicine, the report described a Here, we take a look at some of and has undergone FDA review and range of complications suffered by the the reactions… authorization […] Unfortunately, there women (including vitreous hemorrhages are many unregulated ‘trials’ that are and retinal detachments) after they’d Jeffrey Goldberg, ophthalmologist taking advantage of the desperation received bilateral intravitreal injections at Stanford University, Palo Alto, associated with loss of vision, and of autologous stem cells prepared from California (2): peoples’ vision and lives are at risk.” adipose tissue (1). A year later, one “There is a lot of very well-founded patient was totally blind, and the other evidence for the positive potential of Peter Aldhous, BuzzFeed News two were left with vision ranging from stem [cell] therapy for many human Reporter (6): 20/200 to light perception. So what diseases, but there’s no excuse for not “Inquiries by BuzzFeed News reveal happened? The authors suggest that designing a trial properly and basing it that the original ethical approval raised contamination of the injected material, on preclinical research.” troubling questions from the start […] AVAILABLE NOW! AngioVueHD OCT + OCTA

The Future of High Definition OCTA Imaging Image credit: Thomas Albini.

Left eye of patient two showing diffuse pre-retinal and intraretinal hemorrhage 13 days after intravitreal stem cell injection. Collections of cells can be seen in the vitreous cavity below the optic nerve and in the lower right-hand corner (2).

The ICMS ethical board that approved the trial included one doctor whose medical license had been placed on probation • Higher definition OCTA imaging with 50% more for failing to meet the ‘applicable standard of care’ in his own sampling points in 6mm x 6mm scans. Also medical practice, plus another who had earlier been convicted of available with AngioAnalytics violating federal law by breaching a patient’s medical privacy.” • AngioVueHD Automatic Montage instantly Michael Tomás, CEO of U.S Stem Cell (the company affiliated combines macula and optic disc images for high with the clinic) (3): density wide-field visualization (10mm x 6mm). In a responding statement to the Miami Herald, Tomás wrote • New ultra-fast Retina Raster scans with reduced “For nearly 20 years our clinics have conducted more than speckle-noise provides comprehensive structural 7,000 stem cell procedures with less than 0.01 percent adverse analysis. reactions reported.” According to the article, he declined to comment on the patients involved, but confirmed that the clinic was no longer offering eye treatments. RS

References 1. AE Kuriyan et al., “Vision loss after intravitreal injection of autologous ‘stem cells’ for AMD”, N Engl J Med, 376, 1047–1053 (2017). PMID: 28296617. 2. Stanford Medicine News Center. “Unproven stem cell ‘therapy’ blinds three patients at Florida clinic”, (2017). Available at: http://bit.ly/StanMed. Accessed March 27, 2017. 3. D Chang, Miami Herald. “Three women blinded after stem cell injections at Broward clinic”, (2017). Available at: http://bit.ly/MiamiH. Accessed March 27, 2017. Contact your Optovue representative now to learn more: 4. GQ Daley. “Polar extremes in the clinical use of stem cells”, N Engl J Med, 376, 1075–1077 (2017). PMID: 28296612. www.optovue.com/international-contact/ 5. Foundation Fighting Blindness. “NEJM article on unregulated stem-cell therapy describes severe vision loss for three Florida women”, (2017). Available at: bit.ly/FFBrelease. Accessed March 27, 2017. 6. P Aldhous, “An experiment that blinded three women unearths the murky world of stem cell clinics”, BuzzFeed News (2017). Available at: http://bit.ly/AldhousBuzz. Accessed March 27, 2017.

AngioVue HD Automatic Montage of Diabetic Retinopathy case, courtesy of Adil El Maftouhi, Centre Rabelais, France.

PN 302-52256 Rev A 12 Upfront

50 Cases Controls 44.6

40 34.5 34.3 31.1 31.2 30 24.3 20 Patients (%) Patients Inection 1 10 per year (reference) 0 ≤3 4 – 6 ≥7 ≤3 1.65 Bevacizumab injections per year 3–6 2.48 ≥7

0.5 1 1.5 2 2.5 3 3.5 4 4.5 5 ate ratio

Figure 1. a. Number of number of intravitreous bevacizumab injections per year; b. Adjusted rate ratios for glaucoma surgery stratified by the number of bevacizumab injections received per year. All data were normalized to the ≤3 injections per year group.

for exudative AMD during the years with the RR for patients receiving 3–6 When Multiple of 2009–2013. Next, they identified injections per year being 1.65 (0.84–3.23; a subset of interesting records – ones Figure 1b). The next summit in Punctures that contained glaucoma surgical In an accompanying editorial, Apte et codes for trabeculectomy, complicated al. (2) noted, “most patients who receive refractive performance. Don’t Deflate trabeculectomy, glaucoma drainage intravitreous anti-VEGF injections do devices, and cycloablative procedures not develop ocular hypertension or Repeated bevacizumab (n=74). Ten controls were identified for glaucoma.” However, the authors also injections increase the risk of each of the 74 cases and matched for age, stated that it was “prudent to observe glaucoma surgery prexisting conditions, calendar time, and all patients receiving intravitreous anti- follow-up time for each case (n=740). VEGF injections for evidence of elevated At 12 months, Contoura™ Vision Topography-Guided LASIK patients, It’s now acknowledged that intravitreal Both cases and controls were stratified IOP and glaucoma” and that such without the aid of glasses or contacts, experienced the following results:*,1 injections of anti-VEGF agents do by the number of bevacizumab injections observation was “especially important carry a small risk of increasing patients’ received per year: ≤3, 4–6, and ≥7. for those patients with preexisting ocular IOP – sometimes transiently, sometimes After adjusting for comorbidities, the hypertension or glaucoma.” MH sustained. Many patients receive these proportion of patients who received ≥7 98.4% 30.9% 34.4% 64.8% 92.6% injections monthly, so the question is: how injections per year was 10.3 percent References serious can it get? To find out, a team of greater than the proportion in the control 1. BD Eadie et al., “Association of repeated Vancouver-based ophthalmologists and group (44.6 vs. 34.3 percent; Figure 1a). intravitreous bevacizumab injections with risk of patients said of eyes gained 1 could see 20/12.5 could see 20/16 could see 20/20 researchers got on the case (1). For the case-control analysis, patients for glaucoma surgery”, JAMA Ophthalmology, they would have or more lines over or better or better or better the procedure again baseline BSCVA The team had access to large, linked, who received three or fewer injections [Epub ahead of print] (2016). PMID: population-based heath databases per year served as the reference category; 28301639. For additional information or to schedule a demonstration, contact your Alcon representative. (supported by the British Columbia here, the adjusted rate ratio (RR) of 2. RS Apte et al., “Anti-VEGF injections Ministry of Health) and searched for glaucoma surgery among those who and glaucoma surgery”, JAMA *Post hoc analysis of postoperative UCVA compared to preoperative BSCVA of 230 eyes contained in the FDA T-CAT pivotal trial at 12 months. The primary end point evaluated changes in BSCVA. ® all patients with ophthalmic issues that received seven or more injections per Ophthalmology, [Epub ahead of print] (2016). 1. Results from FDA T-CAT-001 clinical study for Topography-Guided vision correction (with the 400 Hz ALLEGRETTO WAVE Eye-Q Excimer Laser). had received intravitreous bevacizumab year was 2.48 (95% CI, 1.25–4.93), PMID: 28301640.

11443-Alcon-Surg-CONTOURA-OPHTHALMOLOGIST.indd 1 06/04/2016 16:13 The next summit in refractive performance.

At 12 months, Contoura™ Vision Topography-Guided LASIK patients, without the aid of glasses or contacts, experienced the following results:*,1

98.4% 30.9% 34.4% 64.8% 92.6%

of patients said of eyes gained 1 could see 20/12.5 could see 20/16 could see 20/20 they would have or more lines over or better or better or better the procedure again baseline BSCVA

For additional information or to schedule a demonstration, contact your Alcon representative.

*Post hoc analysis of postoperative UCVA compared to preoperative BSCVA of 230 eyes contained in the FDA T-CAT pivotal trial at 12 months. The primary end point evaluated changes in BSCVA. 1. Results from FDA T-CAT-001 clinical study for Topography-Guided vision correction (with the 400 Hz ALLEGRETTO WAVE® Eye-Q Excimer Laser).

11443-Alcon-Surg-CONTOURA-OPHTHALMOLOGIST.indd 1 06/04/2016 16:13

Power List 2017

Thanks to the demographics of the developed world, the future of eyecare looks like it will be one of limited resources and rising patient burden. So who will lead ophthalmology over the next few decades and shape its future? To find out, we asked you, our readers, to vote for ophthalmology’s Top 50 rising stars… and here they are.

Welcome to the 2017 Power List. ocular surface disease related to glaucoma medication toxicity, and the improvement of glaucoma diagnosis using computerized imaging methods. He has authored over 40 scientific publications and book chapters and serves as an active peer-reviewer for several ophthalmic medical journals. He AHMAD AREF has also published a textbook, “Advanced Glaucoma Surgery.” Aref maximizes his time outdoors during the short Chicago ASSISTANT PROFESSOR OF summers by jogging, swimming OPHTHALMOLOGY AT THE and cycling along the Lake Michigan UNIVERSITY OF ILLINOIS AT bike path. CHICAGO (UIC), IL, USA A nominator said: “Aref has taken on several AMIR KASHANI As well as being Assistant Professor of leadership roles in ophthalmology and has Ophthalmology at UIC, Aref directs their written several high-impact papers as well Residency Training Program. He is also an as a textbook, and given several important ASSISTANT PROFESSOR OF attending physician at the Glaucoma and lectures at national and international CLINICAL OPHTHALMOLOGY Cataract Consultation Service at the Illinois meetings as well. In 2018, Aref will be AND DIRECTOR OF THE OCULAR Eye & Ear Infirmary. Aref is interested in completing an MBA in economics and IMAGING CENTER AT USC ROSKI the development of novel glaucoma surgical strategic management from the University EYE INSTITUTE, ARCADIA, CA, USA techniques, the management of dry eye and of Chicago Booth School of Business.” A clinician-scientist developing novel diagnostic and therapeutic methods to A gifted corneal surgeon, Saad, along treat retinal diseases, Kashani is the with his colleague Damien Gatinel, principal investigator for a number of developed an artificial intelligence ongoing trials of stem cell therapies (AI) system for the detection of corneal for the treatment of AMD. He’s also ectasia-susceptible eyes: the SCORE investigating the use of advanced analyzer. A reviewer and editor for imaging spectroscopy and OCT several ophthalmology journals, he methods to improve the diagnosis has over 40 publications to his name. and treatment of retinal diseases, and His research interests include corneal recently co-authored a book entitled ectasias, corneal topography and ‘Optical Coherence Tomography and tomography, wavefront biomechanics OCT Angiography: Clinical Reference and new keratoplasty techniques. and Case Studies.’ An advocate for continued NIH One nominator said: “For his young age funding for research into blinding Saad is not only a great surgeon, already eye diseases, he testified in front of teaching younger colleagues in anterior the US Congress in 2016 to highlight segment surgery, but is also publishing International Age-Related Macular ALAIN SAAD a lot as well as thinking forward and Degeneration Awareness Week and inventing new products to make our life to argue for continued NIH funding easier. His mentality, hard work, and support. Kashani and his wife recently ANTERIOR SEGMENT AND humanity should be an example for all of had their third child – and with three REFRACTIVE SURGERY us. Definitely a top ophthalmologist, if not children under five, his aim is to spend DEPARTMENT, ROTHSCHILD already now, then a few years down time with his family when not in the FOUNDATION, PARIS, FRANCE the road.” clinic or the lab. DMEK

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ophthalmic use. Specifically, he and his team are developing OCT methods to unify and digitally scan the whole ARSHAM SHEYBANI eye. With collaborators at Duke, he is also involved in the development and translation of intra-surgical OCT ASSISTANT PROFESSOR OF technologies including 4D intra-surgical OPHTHALMOLOGY AND VISUAL OCT (live 3D volumes across time). His SCIENCES AT WASHINGTON research is supported by grants awarded UNIVERSITY SCHOOL OF by the National Institutes of Health, the MEDICINE IN ST. LOUIS, !ANTHONY KUO Wallace H. Coulter Foundation, and the MO, USA Department of Defense. He has also been awarded an Alcon Research Institute Sheybani specializes in glaucoma and ASSISTANT PROFESSOR Young Investigator Award, the Dastgheib complex anterior segment surgery. He is OF OPHTHALMOLOGY AND Pioneer Award in Ocular Innovation, and actively involved in research developing BIOMEDICAL ENGINEERING, the Duke Health Scholar Award. devices to improve the safety of glaucoma DUKE UNIVERSITY SCHOOL OF surgery, pseudoexfoliative glaucoma, MEDICINE, DURHAM, NC, USA A nominator said: “We have a lot of stars in malignant glaucoma, and angle closure the field of ophthalmology at Duke but one of glaucoma. Sheybani is an avid surgical Kuo is an Assistant Professor of the fastest rising stars is Kuo. His work that is teacher of residents and fellows, and he Ophthalmology and Biomedical making intraoperative real-time 4D-OCT lectures nationally and internationally on Engineering at Duke University. He is a mainstream is truly remarkable. DSAEK, novel glaucoma surgeries and complex clinician-scientist with an active clinical DMEK, and PDEK procedures in patients surgical cases. Growing up in Louisiana has practice in cornea and refractive surgery and considered complex with poor visibility would left him with a permanent love for crawfish, an active laboratory program developing be impossible without this technology that so he flies live crawfish to St. Louis for a and translating OCT technologies for Kuo is developing and advancing.” yearly boil for friends and family.

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His research interests include transparency Ophthalmology Society Scholar Award. Our upgradeable imaging platform allows you to refine in the doctor-patient relationship, the clinical decision making and gives you the flexibility to effect of electronic medical records, and A nominator said: “Lee is a brilliant cataract surgery outcomes. He currently is ophthalmologist who proves that deep grow your business. Together we can improve patient care. Secretary of the Vanguard Ophthalmology learning in the best institutions can be Society and an ASCRS representative on translated into meaningful clinical work !BRYAN LEE the AAO Council. He also serves on the that can change the world. His academic ASCRS Young Eye Surgeons Clinical achievements speak for themselves. Committee, Phaco Fundamentals Editorial Since completing his training he has dedicated OPHTHALMOLOGIST, ALTOS Board, and the AAO’s Online Education himself to applying his knowledge and skills to EYE PHYSICIANS, LOS ALTOS, Committee, ONE Refractive Management the betterment of his patients and colleagues. 200209-001 INT.AE17 © Heidelberg Engineering GmbH CA, USA Committee, and Refractive Surgery Basic He has authored innumerable articles, book and Clinical Science Course Committee. chapters and the like, and has been a frequent Not only a specialist in cataract, cornea, and A regular presence on top doctor lists, Lee lecturer at all the important meetings. Besides refractive surgery, Lee also has a JD from has also received the Maxwell Grand Prize all of this, Bryan probably has the driest sense Harvard Law School and regularly publishes in Ophthalmology, the Latham Vision of humor of any individual I have ever met, on medicolegal issues in ophthalmology. Research Innovation Award, and Vanguard which proves he is possibly superhuman.” www.be-confident-with-spectralis.com TRUST IN A PROVEN PARTNERSHIP

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CONSULTANT OPHTHALMOLOGIST AND GLAUCOMA LEAD, ROYAL SURREY COUNTY HOSPITAL, make a Move GUILDFORD, UK

Already a prominent glaucoma surgeon, It has never been so simple to adapt new technology into your daily workflow. Lindfield’s main interests are complex cataract surgery, all aspects of glaucoma The truly mobile FEMTO LDV Z8 finally enables you to use next generation surgery and educational research. femtosecond laser technology for your cataract and refractive surgeries. He is a glaucoma surgical trainer, hosting registrars and consultants from England in addition to training device www.femtoldv.com manufacturer employees and surgical trainers from across Europe. He has received several well-recognized national and international awards, including ESCRS Young Ophthalmologist Award, SOS First Prize, UKISCRS Best Video Award, ARVO Young Investigator Award, and has published more than 25 peer-reviewed articles in highly-regarded journals. One of Lindfield’s current research interests is the use of eye movement tracking to detect visual field changes in patients whilst they watch TV on a tablet computer. The work in collaboration with David Crabb at City CAMIEL BOON central serous chorioretinopathy. Boon is University, London, plans to develop also the initiator and principal researcher cheap, readily accessible and novel of multiple treatment trials for diseases technology to aid early detection of eye CONSULTANT of the retina. disease at home. OPHTHALMOLOGIST AND RETINA SPECIALIST, LEIDEN One nominator said: “After doing a According to one nominator, “Dan is a UNIVERSITY MEDICAL CENTRE, PhD on identifying the genetic basis caring, personable ophthalmologist with a THE NETHERLANDS of retinal diseases, and training as an very approachable style to patient care; a ophthalmologist, Camiel Boon did a strong believer in patient education and As well as having active research fellowship in genetics and retina in involvement. Since coming to Guildford, interests, Boon was appointed as Oxford. He then became a faculty member he has built a formidable local glaucoma Professor of Clinical Ophthalmogenetics in Leiden age 34 years, studying the service with excellent treatment and at the University of Amsterdam in genetics of serous chorioretinopathy. training opportunities.” November 2016 – at only 37 years of age. Within three years, he set up his retinal Boon is a fellow of the European Board of surgery clinic, clinical trials, and a Ophthalmology, a board member of the research group with five PhD students. Augencentrum Zytglogge, Dr. Baumann, Berne, Switzerland Medical Retina working group of the Dutch At 37 years of age, he was made a full ophthalmology society, NOG, co-founder professor at the University of Amsterdam, and board member of the European Young running the Delleman genetics archive. Retinal Specialists Society and founder of He is involved in ARVO and founder of the international CHASE Consortium a trans-European young ophthalmologists for clinical and genetic research on group. He is amazing!”

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2017_228_TOP_adv_Triton.indd 1 04-04-17 15:30 23 DRI OCT Triton, Feature Swept Source OCT DAVID ALMEIDA with multi modal imaging VITREORETINAL SURGEON, VITREORETINAL SURGERY, PA, MINNEAPOLIS, MN, USA

A gifted vitreoretinal surgeon, holder of a PhD in Pharmaceutical Drug Research, and co-founder of Citrus Therapeutics and author of over 100 peer-reviewed publications, Almeida’s professional interests (besides ophthalmology) include business innovation and ophthalmic and biomedical research. Almeida writes a weekly blog, the Sunday Surgical Scrub, which can be found on his met him when he was in his fellowship, website davidalmeidamd.com. He is also a and I was amazed by his brilliance competitive squash player and says that in and his talent as a researcher. He’s since his spare time his favorite activity is spending launched his own website, and earlier this time with his wife and three children. year he published his first book, ‘Decision Diagnosis – Seven Antidotes to Decision DUNA RAOOF A nominator said: “If I could invest in a Procrastination,’ which has already made young ophthalmologist that I anticipate me rethink how I make clinical decisions. will do amazing things during his career, I believe David is a perfect fit as a rising PHYSICIAN AT HARVARD EYE Almeida is that type of individual. I first star within ophthalmology.” ASSOCIATES, LAGUNA HILLS, CA, USA

Raoof specializes in cornea, cataract and refractive surgery, and she has been Asan Medical Center and as out-patient granted several honors, including the Assistant Clinical Professor at Severance nation’s most prestigious ophthalmology Hospital, Yonsei University School of award: The Heed Ophthalmic Foundation Medicine in Seoul. His primary passion Fellowship. Raoof’s research interests is corneal wavefront-guided ablation include refractive, cataract, and corneal for amelioration of aberrations for transplant surgery, and her work has led

» Superior visualization of the retina, vitreous and choroid. keratoconus, cornea ectasia, and central to numerous publications in prominent » Remarkable diagnostic capability: Swept Source OCT combined with multimodal islands. Kang has received three Best peer-reviewed publications, including imaging1 (Color, Red-Free, FA,FAF, Anterior OCT2) Academic Achievement Awards from Ophthalmology, Cornea, and The DAVID SUNG YONG KANG the Korean Ophthalmological Society, American Journal of Ophthalmology. » OCT Angiography using Swept Source OCT including the Best Video Award. To An invited speaker at several national date, he has rights to six patents. His first and international meetings, she has also » Unique tracking system provides unmatched accuracy FOUNDER AND CLINICAL patent, registered in 2008, involves using published several textbook chapters on DIRECTOR AT EYEREUM circumlinear capsulorhexis technology LASIK, corneal transplant surgical www.topcon-medical.eu OPHTHALMIC CLINIC AND CEO during cataract surgery. Since then techniques, and dry eye. OF EYEREUM HEALTHCARE, Not available for sale in the US. Not available in all countries, please check with your distributor for availability in your country. he has patented new methods of de- 1 DRI OCT Triton plus : OCT /Anterior OCT (Option)/ Color / Red-Free/ FA / FAF THE REPUBLIC OF KOREA DRI OCT Triton : OCT /Anterior OCT (Option) / Color / Red-Free epithelization of the cornea prior to A nominator said: “A well-trained 2 Option refractive surface ablation, removing ophthalmologist who has written Kang also serves as outpatient Clinical phakic IOLs, and removing lenticules multiple papers, Raoof is a frequent speaker Associate Professor at Ulsan University, during SMILE. at meetings and an excellent surgeon.”

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Vollman’s research interests include healthcare outcomes, cost-effective delivery of healthcare, and quality improvement. He has served a site director for the Ophthalmic Surgery Outcomes Data (OSOD) research project at the St. Louis VA, which has resulted in eight peer-reviewed publications in major ophthalmic journals The first diode pumped SLT device on the market and 21 abstracts presented at national and True portability of the SLT laser device international meetings. Vollman has been !DAVID VOLLMAN recognized with multiple awards for his Very high pulse to pulse stability current and prior leadership, including a ASSISTANT PROFESSOR OF VA St. Louis Medical Staff Award, an DAWN SIM OPHTHALMOLOGY AND VISUAL Achievement Award from the AAO, and SCIENCES AT WASHINGTON the William Oxley Thompson Award for UNIVERSITY SCHOOL OF early career achievement from The Ohio MEDICAL RETINA MEDICINE IN ST. LOUIS, AND State University Alumni Association. He AND CATARACT CONSULTANT CHIEF OF OPHTHALMOLOGY is an avid Ohio State University football AT MOORFIELDS EYE HOSPITAL, AT THE ST. LOUIS VA HEALTH fan and loves to spend time and travel with LONDON, UK CARE SYSTEM, MO, USA his wife and son. Sim is a consultant ophthalmic surgeon in the medical retina service at Moorfields !EDWARD KOROT An ophthalmology resident with a Eye Hospital, and a former chief resident keen interest in the application of novel and current clinical lead for diabetic technology to ophthalmology, Korot screening there. She has a PhD from the RESIDENT PHYSICIAN, started medical school as a TEDMED UCL Institute of Ophthalmology for her DEPARTMENT OF Frontline Scholar. He’s now a leading light work on endothelial progenitor cells in OPHTHALMOLOGY, BEAUMONT in the application of algorithms and AI retinal vascular diseases and has published HOSPITAL, ROYAL OAK, MI, USA to detect signs of disease in ophthalmic extensively on diabetic macular ischemia. images. His first publication described She also has a special interest in the area of the creation of an algorithm that analyzes virtual clinics and teleophthalmology and vitreous cell density in DME – and it is working on device-agnostic platforms to may be the first ever objective measure facilitate acceleration of new technology of vitreous inflammation. His interest into clinical practice. An ARVO Alcon in algorithms and AI had led him to Early Career Research Award winner, collaborate with Pearse Keane (qv) on Dawn is a patent holder for the use of his AI retinal image analysis work. This, Indocyanine Green Dye for visualization combined with his prior experience with of inflammation. A prolific and successful electronic health record consulting, has grant-raiser, Dawn also won the Dermot also led him to consult with Google Pierse prize in 2009 and the 2009 Young Deepmind on their Streams app, which Investigator’s Award at Asia ARVO is being developed to help streamline in 2007. physician alerts and task management. He’s also collaborating with another One nominator said: “Dawn is a great Silicon Valley company, Avegant, to adapt surgeon and a superb researcher. Her their wearable retinal projection display for diabetic retinopathy screening work is some use in ophthalmic microsurgery. of the best in the world.”

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ELIZABETH YEU

ASSISTANT PROFESSOR AT EASTERN VIRGINIA MEDICAL SCHOOL AND CORNEA, CATARACT AND REFRACTIVE SURGEON WITH VIRGINIA EYE CONSULTANTS, NORFOLK, VA, USA

Yeu is a rising leader in the fields of cornea and cataract surgery, in great demand as a speaker at national and international congresses. She cares deeply about education, and currently serves as the Chair of the Young Eye Surgeons Clinical Committee for ASCRS, as EHSAN RAHIMY emerging AI and deep learning platforms, Communications Secretariat for AAO, and how ongoing advancements and further and is the Chief Medical Editor of the integration will transform healthcare peer-reviewed U.S. Ophthalmic Review. SURGICAL AND MEDICAL delivery in the future. In his spare time, While she is a self-proclaimed mediocre- VITREORETINAL SPECIALIST, he enjoys playing recreational sports and to-poor cook in the kitchen today, Yeu PALO ALTO MEDICAL staying active outdoors in the San Francisco supported herself through undergrad and FOUNDATION, SAN CARLOS AND Bay Area. medical school by working as a sushi chef. PALO ALTO, CA, USA One nominator said: “Ehsan is fresh out of A nominator said: “Elizabeth Yeu is a Rahimy has extensive experience researching fellowship but already a respected voice in powerhouse when it comes to clinical, surgical medical and surgical diseases of the retina. the field of vitreoretinal surgery with nearly and academic excellence in ophthalmology. He has over 80 peer-reviewed publications, a hundred publications and book chapters as Her productivity and value as a key opinion has contributed to more than 100 abstracts well as countless lectures and presentations to and thought leader in ophthalmology are presented at national and international his name. His clinical acumen is unmatched only eclipsed by the quality of her surgical ophthalmic meetings, and has numerous for an ophthalmologist at his level of skills and clinical acumen. Additionally, she first-authored book chapters as well as other training, and colleagues often consult him on has already thrived in the academic setting, non-peer reviewed articles. His research difficult and challenging cases from around publishing multiple peer-reviewed articles, interests include macular degeneration, the country. He reserves time for education book chapters, and has given too many diabetic retinopathy, retinal vein occlusion, as well, traveling the country to prepare lectures to count. Having personally observed novel retinal imaging platforms, and residents for their in-service examinations. her in each of these arenas, she is definitely a telemedicine in ophthalmology. He has a He undoubtedly will be one of the big names member of ophthalmology’s most elite class. particular interest in the interplay between in retina, ophthalmology, and beyond in the She’s also a fantastic role model for young technology and medicine, notably with years to come.” female ophthalmologists.” When changing your IOL makes a big difference. ZEISS CT LUCIA (SN60WF), the ZEISS CT LUCIA performed performed LUCIA (SN60WF), the ZEISS CT ® (SN60WF) with 90 seconds. The ZEISS CT LUCIA showed a faster centration after insertion in the capsular bag with less after insertion in the capsular bag with less showed a faster centration LUCIA (SN60WF) with 90 seconds. The ZEISS CT ® (SN60WF). The measured implantation steps included: insertion, injection, unfolding and centration. Study not published. Data on ﬁ le. implantation steps included: insertion, injection, unfolding not published. Data on ﬁ (SN60WF). The measured Study and centration. ®

// PRECISION MADE BY ZEISS manipulation required, compared to Alcon AcrySof compared manipulation required, *During the statistical evaluation of implantation times, carried out by the David J Apple International Laboratory for Ocular Pathology, International Vision Correction Research Centre (IVCRC), (IVCRC), International VisionCentre Research Correction for Ocular Pathology, *During the statistical evaluation of implantation times, carried out by David J Apple International Laboratory and the Alcon AcrySof LUCIA Auffarth, MD, PhD, FEBO.,comparing the ZEISS CT Chairman: G.U. University of Heidelberg, Department of Ophthalmology, with a total implantation time of 70 seconds versus the Alcon AcrySof

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More than ever, successful science requires strong global connections — among researchers, across disciplines and between generations. The ARVO MAY 7 – 11 | BALTIMORE 2017 Annual Meeting will bring GLOBAL CONNECTIONS IN VISION RESEARCH together more than 11,000 top eye and vision researchers and clinicians form around the world to explore cutting-edge basic and clinical science.

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ARVO’s Online Education — designed by vision researchers for visions researchers — offers essential training and career development for clinician- scientists at all career levels. Self-paced modules and videos are free to members. Nonmembers can sample select resources and session recordings. arvo.org/online_education 29 Discover the science that Feature will change your practice

More than ever, successful science requires strong global connections — among researchers, across disciplines ELLIOT SOHN FLORIAN KRETZ and between generations. The ARVO MAY 7 – 11 | BALTIMORE ASSOCIATE PROFESSOR AND 2017 Annual Meeting will bring GLOBAL CONNECTIONS IN VISION RESEARCH DIRECTOR OF THE SURGICAL AND CHIEF EXECUTIVE OFFICER & together more than 11,000 top eye MEDICAL RETINA FELLOWSHIPS AT LEAD SURGEON AT EYECLINICS and vision researchers and clinicians THE UNIVERSITY OF IOWA, IA, USA AHAUS-GREVEN-RAESFELD- form around the world to explore RHEINE; CONSULTANT AND cutting-edge basic and clinical science. Sohn serves ARVO as Chair of the RESEARCH COORDINATOR OF Retina (RE) section of the Annual THE INTERNATIONAL VISION Meeting Program Committee; the CORRECTION RESEARCH AAO as subcommittee reviewer (retina- CENTRE NETWORK (IVCRC. vitreous) for the Annual Meeting NET), DEPARTMENT OF Program Committee and a member of the OPHTHALMOLOGY, UNIVERSITY Committee on Aging; and the American OF HEIDELBERG, GERMANY ARVO Board of Ophthalmology as an oral The Association for Research examiner and item writing committee Kretz is a cataract and refractive surgeon in Vision and Ophthalmology member. He has written or co-authored who also has subspecialties in glaucoma over 45 peer-reviewed manuscripts and and medical retina. He is well-known as a five book chapters, and recently served speaker at the large international congresses, Uganda. Their next project is a cooperation as Associate Book Editor for the AAO describing the results of the latest premium with the Cambodian NGO CISA-Khmer Basic Techniques of Ophthalmic Surgery, IOLs and patient assessment methods that Sight Foundation, together with Sunil 3rd edition. He is on the editorial board best match the patient with the right IOL Shah and many internationally renowned of Scientific Reports, has been voted one for them. He is also the CEO of Eyedoctors ophthalmologists. The aim is to establish of the ‘Best Doctors in America’ and is for the world (“Augenärzte für die Welt”), a center of excellence in Cambodia where ONLINE a member of the Macula Society, Retina a non-profit NGO that supports eyecare the organization can treat the population New Society, American Society of Retina around the globe and has recently developed for preventable blindness, and train local Specialists, European Society of Retina and established an eye clinic in Kasana, ophthalmologists and staff. EDUCATION Specialists, and Vail Vitrectomy. Sohn is active in basic and translational ARVO’s Online Education — research and is developing surgical tools, performing human clinical trials, and designed by vision researchers completing preclinical gene and autologous IRA SCHACHAR Schachar’s clinical and research work stem cell studies in pigs to treat inherited has already involved some of the biggest for visions researchers — offers retinal degenerations. He is the PI of names in ophthalmology. His research essential training and career the NIH R01 grant ‘Choroidal Disease ASSISTANT PROFESSOR interests include (but aren’t limited to) Mechanisms in AMD.’ OF OPHTHALMOLOGY AT AMD and retinopathy of prematurity – development for clinician- STANFORD UNIVERSITY and he is a committed innovator in the scientists at all career levels. One nominator said: “Sohn is a vitreoretinal MEDICAL CENTER, STANFORD, retina space, with his name already on surgeon, young researcher and active leader CA,USA many ophthalmic patents. Self-paced modules and with enormous potential. His recent work suggests that retinal diabetic neuropathy causes After completing his residency at Kellogg One nominator said: “Ira Schachar is videos are free to members. progressive damage to the nerve cells in the Eye Center, Schachar moved to Stanford perhaps the most innovative person in the Nonmembers can sample select retina before any signs of damage to retinal University, and is affiliated with multiple field of ophthalmology. With outside the box blood vessels, which opens a new paradigm for hospitals, including Stanford Hospital thinking, he has created several uniquely resources and session recordings. the study and treatment of diabetic eye disease. and Clinics and VA Palo Alto Hospital. innovative projects leading to successful start- Sohn is also a great clinician, educator, and an Already working with at the cutting ups in the field of ophthalmic innovation. arvo.org/online_education all-round nice guy.” edge of imaging and surgical technology, He is devoted to resident education.

www.theophthalmologist.com 30 Feature

female leading ophthalmologists (which merged with the CEDARS group in 2015), Loh is a hard-working comprehensive ophthalmologist who has a particular focus on refractive and femtosecond laser-assisted cataract surgery. As a medical student, she was inducted into the Indiana University chapter of the Gold Humanism Honor Society and was also fortunate to serve as chief resident for both her intern year and JENNIFER LOH ophthalmology residency class, and today Loh participates on the faculty of many conferences. In 2016, she received the RSA’s PHYSICIAN AT LOH President’s Award. Away from the clinic, OPHTHALMOLOGY ASSOCIATES Loh is learning to ski – blue runs are now AND SOUTH FLORIDA VISION being conquered; black runs are next! ASSOCIATES, FL, USA One nominator said: “Jennifer Loh is a hard A founder and executive board member working compassionate young ophthalmologist of the Refractive Surgery Alliance (RSA), who has focused her energy on making a and a founder of the ASPENS group of difference for her patients – and her colleagues.” IRINI CHATZIRALLI

ACADEMIC UNIVERSITY SCHOLAR AT NATIONAL AND KAPODISTRIAN UNIVERSITY OF JOSEPH NEZGODA ATHENS, GREECE

Chatziralli is an ophthalmic surgeon RETINA PHYSICIAN AND specializing in medical retina. She SURGEON AT FLORIDA EYE is actively involved in many research MICROSURGICAL INSTITUTE, projects and has over 100 publications WELLINGTON, FL, USA in peer-reviewed journals. One of her favorite hobbies is music and she has Nezgoda is a fellowship-trained retina played piano for around 25 years. She specialist focusing on the medical and says that photography is her other love surgical treatment of macular degeneration, outside ophthalmology. diabetic retinopathy, retinal detachment, For his contributions to the field, Nezgoda and inflammatory eye disease. He studied at received the prestigious Leadership in A nominator said: “Irini is an exceptional UMDNJ-Robert Wood Johnson Medical Medicine Award from the American personality. She has great research activity School (now Rutgers University), where Medical Association, and the Achievement that is proven by her prolific publication he received several named scholarships Award of the AAO. He has trained at Mt. record. She is also a very good and precise including the Gold Humanism Honor Sinai (NY), The Cleveland Medical Center, surgeon, as well as a medical retina Society, and the Excellence in Teaching The University of California-San Diego, specialist. I recommend her as a ‘Rising Star’ Award “in honor of dedicated service to and has served on numerous editorial in ophthalmology without any hesitation. clinical skills education in the preclinical review boards, authored several scientific She is a voracious researcher and an asset years” for being the first coordinator of the publications, and has presented at numerous in each clinic! Her clinical and research Student Teaching Elective – he was the only meetings. He also serves on the Collections experience is outstanding non-faculty member to receive this award. Committee of The Museum www.theophthalmologist.com 32 Feature

KAWEH MANSOURI KAROLINNE ROCHA CONSULTANT OPHTHALMOLOGIST, ASSISTANT PROFESSOR OF Here’s what a nominator had to say: “Rocha is GLAUCOMA CENTRE, OPHTHALMOLOGY, MEDICAL an optics expert, tremendous researcher, great MONTCHOISI CLINIC, UNIVERSITY OF SOUTH CAROLINA speaker, and delightful person. She is one of LAUSANNE, SWITZERLAND (MUSC), CHARLESTON, SC, USA a handful of young women that will forever influence our wonderful profession.” As well as being a consultant Rocha specializes in cataract, cornea, ophthalmologist at Montchoisi Clinic, and refractive surgery at MUSC - Storm Lausanne, Switzerland, Mansouri is Eye Institute. She has received several also an Adjunct Associate Professor awards and distinctions for excellence at the Department of Ophthalmology in ophthalmology including the AAO at the University of Colorado. He Achievement Award in 2012, the pioneered the use of 24-hour IOP- ASCRS foundation resident excellence monitoring technology for patients award in 2012 and the Cleveland Clinic with glaucoma by contributing to Lerner College of Medicine teaching the development of the IOP-sensing excellence recognition award in 2013. contact lens, Triggerfish, and was Rocha is active in clinical research, the first ophthalmologist to give a having published over 100 scientific TEDx talk. A MIGS pioneer, Kaweh works including peer review publications, leads many instructional courses at book chapters, and abstracts in international meetings and has over 65 society meetings. peer-reviewed publications to his name. Mansouri is an avid skier, and if he is not in the office, he is in the mountains. LEJLA VAJZOVIC A nominator said: “In my humble view, Mansouri is by far one of the PHYSICIAN AT DUKE PEDIATRIC most gifted clinical talents across all RETINA AND OPTIC NERVE relevant ophthalmological bases: clinical CENTER, DURHAM, NC, USA and surgical expertise, his ‘what’s possible’ attitude to research and future With specific expertise and interest in industry trends, his collaboration with advanced pediatric retinal surgery, Vajzovic industry, and his ability to communicate is the director of the Duke Center for effectively with colleagues and patients.” Artificial and Regenerative Vision. She has a great enthusiasm for teaching the next generation of retinal surgeons and organizes and directs several national and international courses. With interests in retinal implants and stem cell technology, Vajzovic’s scientific the Heed Ophthalmic Fellowship Award, contributions focus on histopathology of the Society of Heed Fellows Award, and various ocular tissues and the development of the ASRS Honor Award. Married with neurosensory retina in healthy and diseased two children, her favorite activity is spending eyes. Vajzovic has received numerous honors time with her family, but she also enjoys and awards for excellence in clinical care downhill skiing, having qualified for an and ophthalmology research, including the Olympic racing team during her childhood Retina Society Fellowship Research Award, years in Bosnia and Herzegovina. Supporting Ophthalmology’s Leaders of Tomorrow

The 2017 Ophthalmologist Power List celebrates those outstanding individuals who have been recognized by their peers as having the inspirational qualities of a future leader in ophthalmology. These are the eye care professionals that will shape the future of eye care. Here, our industry sponsors tell us why their work with those in the early stages of their career is so important to them and to ophthalmology’s future…

www.theophthalmologist.com Gerry Muhle Vice President & Head of International Strategic Marketing – Ophthalmology at Allergan

What initiatives is Allergan involved What importance does Allergan will continue to embrace and utilize in to support ophthalmologists in the place on working with early-stage it for collaboration on an increasingly early stages of their career? career ophthalmologists? global scale, as well as sharing ideas In 2003 Allergan established a unique In an ever-changing healthcare and best practice, with the goal initiative for early career stage glaucoma landscape, working with early-stage to make access to care easier and specialists (the International Glaucoma career ophthalmologists who are open more convenient. Programme), this was further to or indeed driving revolutionary developed and in 2009 the first young ideas and new approaches, is extremely What characteristics make an retina specialist group was started (the important to Allergan. Working ophthalmologist one of International Retina Programme). closely with the specialties we serve tomorrow’s leaders? Allergan sponsors these comprehensive ensures we focus on products and Tomorrow’s leaders are curious; they 3-year programmes. They are developed services that make a real difference challenge existing thinking and are and led by world recognized glaucoma to people’s vision and lives. We not afraid to question current practice. and retina specialists, ensuring that the know that great ideas come from They are self-starters and understand content is high quality and relevant working with the profession to gain the importance of collaboration. to the speciality. Delegates are a deep understanding of their needs Above all, they have a passion for suggested by leaders in the different and constraints. preventing vision loss and improving countries, as to be their countries next ocular health. generation leaders. Throughout the What impact will tomorrow’s programme, participants learn from leaders have on the future renowned experts and build relations of ophthalmology? with young doctors from different As technology increasingly pervades parts of the world. Whilst the remit healthcare (ophthalmologists is educational, independently the have always been early adopters of groups are productive, coming up with technology) and the increasing demand new approaches to clinical problems, for eyecare, tomorrow’s leaders will publishing papers and establishing more readily and seamlessly integrate study protocols. this into their everyday practice. They

www.allergan.com Jim Mazzo Global President Ophthalmic Devices, Carl Zeiss Meditec

What initiatives is ZEISS involved years of experience, but also the “rising technology to be refined for broader use in that support ophthalmologists in stars” who bring new ideas and fresh in the future. Many researchers in ARI the early stages of their career? perspectives. After all, the rising stars of are veterans of ophthalmology, but many ZEISS is totally committed to engaging yesteryear have helped shape eye care and are young rising stars who are pushing the and supporting young ophthalmologists ophthalmology as we know it today, and boundaries of discovery, and with it, the early in their career. An important today’s rising stars will shape our future. future of medicine. element of achieving this is by our significant investment in clinical What impact will tomorrow’s leaders What characteristics make an education, such as resident educational have on the future of ophthalmology? ophthalmologist one of events, on a local, regional, national and Here’s one example: ZEISS closely tomorrow’s leaders? international level. We actively encourage collaborates with ophthalmologists and New technologies like SMILE, ZEISS and support young ophthalmologists as clinical researchers in the Advanced Retina Cataract Suite markerless, and the they refine their surgical and clinical skill, Imaging Network (ARI). They have an integrated data management platform, as well as engaging them on emerging opportunity to build investigator-led FORUM from ZEISS, are changing technology and how it can be adopted research studies across the ARI Network clinical practice today – improving into practice to advance care. to gain a deeper understanding of retinal workflow and patients’ outcomes. The disease in ways never seen before by ARI Network with ZEISS PLEX Elite What importance does ZEISS place utilizing ZEISS’ PLEX Elite Swept Source is already advancing retinal research at a on working with early-stage career OCT / OCT Angiography platform. rapid pace, and with it, clinical practice. ophthalmologists? The Network gives them an opportunity An ophthalmologist that adopts these ZEISS’ success has been founded on to mentor rising stars and to publish their technologies, and even moreso, participates two interwoven fundamentals: our results helping the entire retina community. in their development will, without a doubt, technological expertise and our close Using an advanced online collaboration change the face of ophthalmology. collaboration with doctors. ZEISS’ platform, the ARI researchers around innovations in medical technology – the world collaborate with each other and many now the standard of care – would the scientists and engineers at ZEISS not have been possible without close to develop tools and technologies that collaboration with doctors – those with further advance research and allow OCT

www.zeiss.com/med Tom Frinzi Worldwide President, Surgical Johnson & Johnson Vision

What initiatives is Johnson & a key part giving ophthalmologists and a passion for exploring new Johnson Vision involved in to exclusive access to special training ideas will be influential for any support ophthalmologists in the programs with state-of-the-art ophthalmologist. An ophthalmologist early stages of their career? equipment and connecting them to must also bring with them drive and Johnson & Johnson Vision is our unique network of professionals determination for better patient committed and dedicated to and KOLs with deep expertise. outcomes. Someone working in this partnering with leading institutions challenging, but rewarding field around the world, in fact Johnson What impact will tomorrow’s must be committed to improving and and Johnson is currently in over 100 leaders have on the future restoring sight for people around the teaching institutes globally. We will of ophthalmology? world. That determination to succeed continue our best efforts in working As the next generation of leaders will serve them well as their career with major residency programs to comes forward, their impact will be develops into tomorrow’s leader. conduct research and development, similar to many of their predecessors explore advancement in technology, and mentors. There is a substantial and manage information sharing unmet need in eye health that needs programs – influencing those who to be addressed and I believe many of continue to pursue the field. them will go on to drive innovation in technology and become pioneers What importance does Johnson of new surgical procedures – paving & Johnson Vision place on the path for future leaders. The stakes working with early-stage career are high with 50% of the world’s ophthalmologists? population needing vision correction Johnson & Johnson Vision has been an and only 10% are treated. active member with the Millennial Eye Symposium, an organization focused What characteristics make an on the development and mentorship ophthalmologist one of for ophthalmologists under 40, for tomorrow’s leaders? many years. We will continue to play Intellectual curiosity for technology

www.jnjvision.com Mike Ball Division Head and CEO, Alcon

What initiatives is Alcon involved in the early stages of their medical initiative to continually improve one’s to support ophthalmologists in the journeys. We aim to serve as a trusted skill sets through innovation and new early stages of their career? partner for doctors throughout their techniques, is critical. For instance, We host comprehensive educational careers because their insights are patient expectations continue to programs around the world, including critical in shaping our strategy and evolve as people now live their lives on at the Alcon Customer Experience product pipeline. mobile devices. Adoption of advanced Center. The Center offers an immersive IOL technologies will be a necessity training environment, complete What impact will tomorrow’s for many practices. As patients with exam lanes and enhanced wet leaders have on the future evolve, industry and surgeons must labs, for both new and experienced of ophthalmology? also evolve. practitioners. In addition, our Hospital Tomorrow’s leaders are key in Account Managers work with residents helping us identify the industry’s and attending physicians to educate unmet needs. Working closely with and train future ophthalmologists, Alcon development teams, these and we also partner with the individuals help advance unmet ASCRS YES program to provide needs through product ideation and unrestricted educational grants to help development, with the potential to train new surgeons. see their contributions come to life in the operating theater in the future. What importance does Alcon This partnership is critical to the place on working with early-stage improvement of patient outcomes and career ophthalmologists? quality of life through innovation. As an industry leader, we recognize that our dedication to improving What characteristics make an patients’ lives through innovation can ophthalmologist one of only be realized through our long- tomorrow’s leaders? term partnerships with our customers. An unwavering goal of raising the These relationships often begin at bar in patient outcomes, with the

www.alcon.com UNITING THE LEADERS IN THE DEVELOPMENT OF GROUND-BREAKING OPHTHALMIC TECHNOLOGIES.

UPCOMING EVENTS

MAY 4TH, 2017 LOS ANGELES, CA SHERATON GRAND LOS ANGELES

AUGUST 10TH, 2017 BOSTON, MA SHERATON BOSTON HOTEL

NOVEMBER 9TH, 2017 NEW ORLEANS, LA HYATT REGENCY NEW ORLEANS

The Ophthalmology Innovation Summit is for me the highlight of both the ASCRS and AAO Meetings. This meeting is packed with useful information for the ophthalmologist, industry executive and investor that is simply not available in any other venue. I consider OIS to be a cannot miss meeting.

Richard Lindstrom, MD

I love OIS, nothing else comes close in presenting the total picture of Ophthalmology with all of it’s Business, Financing and Strategy.

Stephen Slade, MD SIGN UP TODAY! OIS.NET 39 UNITING THE LEADERS IN THE DEVELOPMENT Feature OF GROUND-BREAKING OPHTHALMIC TECHNOLOGIES. PROFESSOR OF LASIK ectasia, and corneal cross-linking OPHTHALMOLOGY AT THE protocol development. FEDERAL UNIVERSITY OF RIO DE JANEIRO AND THE A nominator said: “Marcony is an UPCOMING EVENTS UNIVERSITY OF SAO PAULO, extremely thoughtful person who is full BRAZIL; ADJUNCT PROFESSOR of great ideas and always gives inspiring OF OPHTHALMOLOGY AT THE talks. He has received more than 15 UNIVERSITY OF SOUTHERN international awards and has provided MAY 4TH, 2017 CALIFORNIA, USA significant contributions to the field of LOS ANGELES, CA ophthalmology. At only 37 years old, he’s SHERATON GRAND LOS ANGELES Santhiago’s areas of expertise include a professor and PhD mentor at the most corneal and intraocular refractive respected university in his country. He is surgical procedures including LASIK, also the associate editor of JRS and section AUGUST 10TH, 2017 premium laser-assisted cataract and editor of JCRS. BOSTON, MA IOL surgery, and the management of Marcony is a young ophthalmologist that SHERATON BOSTON HOTEL corneal ectatic disorders. His primary has become a leader in refractive surgery. research focus is the identification Among his contributions, he identified a !MARCONY SANTHIAGO and management of corneal ectatic previously unknown risk factor for ectasia: diseases, including keratoconus and post- the percentage of tissue altered.” NOVEMBER 9TH, 2017 NEW ORLEANS, LA HYATT REGENCY NEW ORLEANS

MARTIN DIRISAMER

The Ophthalmology Innovation Summit is CORNEA CONSULTANT for me the highlight of both the ASCRS and AT THE DEPARTMENT OF AAO Meetings. This meeting is packed with OPHTHALMOLOGY, UNIVERSITY useful information for the ophthalmologist, MUNICH (LMU), GERMANY industry executive and investor that is simply Dirisamer is also co-owner of the Smile not available in any other venue. I consider Eyes refractive laser clinic in Linz, OIS to be a cannot miss meeting. Austria. In 2010, he undertook a one- and-a-half year fellowship with Gerrit Melles at the Netherlands Institute for Innovative Ocular Surgery in Rotterdam, Richard Lindstrom, MD during which he gained an international reputation in the field of modern corneal transplantation. I love OIS, nothing else comes close in presenting He has published over 30 articles the total picture of Ophthalmology with all of it’s about DMEK and was the first Business, Financing and Strategy. author on the publication that described the Descemet membrane One nominator said: “Martin is one of shows that even at his young age, he has endothelial transfer procedure for the the most gifted young corneal surgeons already made a huge difference to our first time. He received his habilitation in and researchers I’ve seen to date. His understanding of corneal endothelial Stephen Slade, MD 2015… and by all accounts, is an expert research on endothelial cell migration and cell disorders. I believe his work will SIGN UP TODAY! amateur winemaker. regeneration in DMEK surgery, and his eventually rank up there along with the OIS. first description of the DMET procedure likes of Melles and Barraquer.” NET www.theophthalmologist.com 40 Feature

What are we missing? See more, treat more with optomap®

MATUS REHAK optomap plus Courtesy of SriniVas Sadda, MD optomap af Courtesy of SriniVas Sadda, MD

PROFESSOR OF OPHTHALMOLOGY, THE UNIVERSITY OF LEIPZIG, GERMANY

A retina surgeon and anti-VEGF expert, Rehak’s research interests include retinal vascular diseases, such as diabetic retinopathy and retinal vein occlusion, and ocular oncology. His research work is starting to reveal how the molecular and anatomical changes in these disease states are linked, and he has optomap fa Courtesy of Paulo Stanga, MD optomap icg Courtesy of SriniVas Sadda, MD been involved in the clinical evaluation of anti-VEGF and laser treatment strategies for retinal occlusive disease. “Seeing more of the retina provides greater insight, improves diagnosis and management. He also has an interest in radiation of Ophthalmology, University of Bonn, MONIKA FLECKENSTEIN Without seeing, we cannot treat. Ultra-widefieldopto map imaging has set the standard and proton beam therapy (PBT) for Germany, Fleckenstein has a special focus of care, it is difficult to imagine going back to standard fundus photography”. intraocular tumors, and his work has on the design, conduct, and analysis of helped define predictive risk factors for CLINICIAN-SCIENTIST, interventional clinical trials of retinal disease Prof Paulo E. Stanga, Manchester Royal Eye Hospital, UK retinopathy and optic neuropathy after DEPARTMENT OF therapies, and it’s this expertise in clinical PBT, helping improve treatment choices OPHTHALMOLOGY, UNIVERSITY trials that has led to her membership of the ▶ 200º non-distorted images of the retina, OF BONN, GERMANY and the safety profiles when using these University of Bonn’s institutional review up to 82% in a single capture treatment modalities. board/independent Ethics Committee. Fleckenstein is a world expert in the field She is also a co-founder of Young ▶ Clinically supported by 400+ studies A nominator said: “Rehak is ambitious in of AMD and retinal imaging, and her European Retina Specialists (YOURS), ▶ 5 imaging modes; colour | red-free | af fa | | icg spreading knowledge, works cooperatively seminal research work has substantially an initiative to promote interaction and and makes patient-orientated decisions. A contributed to the understanding of the collaboration between young retinal skilled specialist on difficult disease states disease manifestation and natural history specialists within Europe. In her free time, Visit www.optos.com to find out more or contact us [email protected] of the retina, he has a friendly and of geographic atrophy. As the head of the Fleckenstein loves to watch her children’s or +44 (0)1383 843350 open character.” Clinical Trial Center at the Department soccer games.

© 2017 Optos. All rights reserved. Optos®, optos® and optomap® are registered trademarks of Optos plc. Registered in Scotland Number: SC139953. Registered Office: Queensferry House, Carnegie Campus, Dunfermline, Fife, KY11 8GR, UK. What are we missing? See more, treat more with optomap®

optomap plus Courtesy of SriniVas Sadda, MD optomap af Courtesy of SriniVas Sadda, MD

optomap fa Courtesy of Paulo Stanga, MD optomap icg Courtesy of SriniVas Sadda, MD

“Seeing more of the retina provides greater insight, improves diagnosis and management. Without seeing, we cannot treat. Ultra-widefieldopto map imaging has set the standard of care, it is difficult to imagine going back to standard fundus photography”. Prof Paulo E. Stanga, Manchester Royal Eye Hospital, UK

▶ 200º non-distorted images of the retina, up to 82% in a single capture ▶ Clinically supported by 400+ studies ▶ 5 imaging modes; colour | red-free | af fa | | icg

Visit www.optos.com to find out more or contact us [email protected] or +44 (0)1383 843350

Feature 43

PATRICIA UDAONDO Institute at Johns Hopkins University in the past. Today, she’s a leading light in age- related retinal diseases, particularly DME, FACULTY MEMBER, DEPARTMENT and she is a regular speaker at international OF OPHTHALMOLOGY, NEW congresses and symposia. UNIVERSITY AND POLYTECHNIC Outside of work, Udaondo loves sport; HOSPITAL LA FE, VALENCIA, her next challenge is an Iron Man (half- !NETAN CHOUDHRY SPAIN; CO-FOUNDER AND distance triathlon) in Mallorca in May. MEDICAL DIRECTOR OF THE She also likes animals: her pets include AIKEN CLINIC IN VALENCIA a parrot, a turtle, and a dog. She loves to FOUNDER AND MEDICAL live with – and for – music: she listens to DIRECTOR OF VITREOUS Author of over 70 PubMed-listed music whenever she’s performing surgery, RETINA MACULA SPECIALISTS publications, Udaondo has received the training or just walking. OF TORONTO, ON, CANADA highest honors (best CV) from the Hospital General Universitario de Valencia, where Here’s what a nominator had to say about Choudhry is an internationally recognized she specialized in ophthalmology. She’s her: “Bright, hard working, does a lot of and renowned vitreoretinal surgeon, undertaken rotations at La Paz University research, and founded a big clinic that serves with affiliations at both the University of Hospital in Madrid and the Wilmer Eye all of her area.” Toronto and Harvard Medical School, and is a faculty member at the Cleveland Clinic Canada (in Toronto). A leader in retinal imaging and the diagnosis and treatment of rare disorders of the retina and vitreous, Choudhry was the first to pioneer OCT imaging of the peripheral retina, and he is actively developing novel devices for imaging the retina and vitreous using non-invasive technology. Choudhry has published several book chapters in retinal medicine and wide-field imaging and has received research grants to investigate diabetic retinopathy, AMD, macular holes/puckers and uncommon conditions such as retinitis pigmentosa and macular telangiectasia. In his spare time, he enjoys taking his kids to watch the Toronto Maple Leafs hockey team play.

A nominator said: “Netan Choudhry has become a pioneer in OCT retinal imaging over the last several years. He has developed novel techniques and helped image the retinal periphery as never before seen. He had a landmark publication in Ophthalmology in 2016 and has followed up with a swept-source OCT evaluation of the retinal periphery. Choudhry is changing the way we view the retinal periphery, and how we use our OCT machines.” 44 Feature

PHYSICIAN AT OREGON EYE international events, Karth is also one of CONSULTANTS AND ADJUNCT ophthalmology’s most active proponents ASSISTANT CLINICAL of physicians in social media. PROFESSOR, STANFORD UNIVERSITY, CA, USA A nominator said: “Peter is tremendously dedicated to finding novel solutions to issues In addition to patient care, Karth is active in the field of ophthalmology – I worked in health tech, teleophthalmology, AI, with him on developing a novel mobile app and medical devices. He is a co-founder for vision testing and monitoring, which of a medical device/health tech start- proactively detects the progression of retinal up and also consults for Silicon Valley’s diseases. His dedication and contributions most prestigious tech firms, including to the technological advances in this Google and Apple. A regular contributor field, both with his work in industry and PETER KARTH to many popular and peer-reviewed academia, make him a clear rising star publications who presents at national and in ophthalmology.”

RANYA HABASH

CHIEF MEDICAL OFFICER, EVERBRIDGE; ASSISTANT PROFESSOR OF OPHTHALMOLOGY AT BASCOM PALMER EYE INSTITUTE, MIAMI, FL, USA

Habash was named to Castle Connolly’s elite America’s Top Doctors list for 2015, and was named Young Ophthalmologist of the Year in 2008 by the Florida Society for Ophthalmology, then served as its President- elect. She is also deeply involved in the information technology aspect of medicine, as Chief Medical Officer of Everbridge and Co-Founder of HipaaBridge. She was listed by Becker’s Hospital Review as a Top Healthcare Entrepreneur to Know for 2016.

A nominator said: “Aside from being faculty at Bascom Palmer, Habash is the Chief Medical Officer for a global software company, striving to put better tech into medicine. She is also working to implement tele-retina and second opinion consults for patients who need better access to the experts at Bascom Palmer.” 2016 Winner see sr

ate Nominations iig for the 2017 Humanity in oect Science Award are now open o

R A I

e Humanity in Science Award recognizes and rewards a scienti c project that has the potential to make the world a better place. Do you know of a project that is worthy of the prize? oite roet wit itri it ow t wwwitisieewro Nominations close on May 1st 2017

humanityinscienceaward.com [email protected] @humanityaward humanityinscienceaward humanityinscience Hill-RBF: » Pursuing a new level of accuracy « WARREN E. HILL , MD, FACS / MESA, ARIZONA, USA

LENSTAR LS 900 Improving outcomes !STEFFEN SCHMITZ-VALCKENBERG

ASSISTANT MEDICAL DIRECTOR OF THE DEPARTMENT OF OPHTHALMOLOGY, UNIVERSITY Hill-RBF Method OF BONN, GERMANY The Hill-RBF Method is a complete new approach for IOL power selection. RBF stands for Radial Basis activation Function. The calculation is driven by an Schmitz-Valckenberg’s research focuses on AMD, retinal advanced, self-validating method using pattern recog- imaging, fundus autofluorescence and molecular imaging. He nition based on artificial intelligence and sophisticated has contributed to over 90 publications and 16 book chapters data interpolation. and acted as co-editor of the Atlas of Fundus Autofluorescence Imaging. He predicts that the next big advance in ophthalmology EyeSuite IOL will be the increasing number of intravitreal agents available for The Hill-RBF Method is included exclusively in the the treatment of retinal diseases as well as the more precise latest EyeSuite software. In addition to the new calcu- longitudinal structural-function analysis of retinal diseases. lator, EyeSuite provides state of the art IOL calculation formulae such as Olsen, Barrett’s Universal II, True K A nominator said: “Schmitz-Valckenberg has made major and Toric Calculator. Up to 12 formulae are eligible contributions to the field of retinal imaging and biomarkers in in a user-friendly interface to match any surgeons the context of geographic atrophy due to AMD, and he is an demandings. internationally renowned expert on fundus autofluorescence imaging by confocal scanning laser ophthalmoscopy. He also has a huge array of high-ranked, peer-reviewed scientific publications and is a recipient of various scientific awards.” www.haag-streit.com

ADV_Lenstar_Hill-RBF_Ophthalmologist_Powerlist_2017.indd 1 04.04.2017 16:43:49 Feature 47

his research findings. He has also been involved in shaping injury prevention laws in the states of Maryland and Florida. Haring is fluent in Russian, was once a door-to-door salesman, and enjoys fishing in his spare time.

A nominator said: “Haring’s research has established him as a standout in the field of ocular trauma and injury epidemiology. Three of his papers in the past 6 months have been among the ‘most talked about’ studies in ophthalmology. Despite his young age and status as an early-career researcher, his work has been featured twice in the New York Times, as well as the Today show, CNN, BBC, and dozens of television, radio, and internet outlets across the country and the world. His work aims to reduce R. STERLING HARING Haring has published many studies on the incidence of critical eye injuries through ocular injuries and trauma, and his research correct understanding, awareness, and was listed among JAMA Ophthalmology’s evidence-based prevention mechanisms, INJURY RESEARCHER, JOHNS “most talked about in 2016.” He is actively and he continues to work with media and HOPKINS BLOOMBERG SCHOOL involved in increasing awareness of ocular government partners in getting OF PUBLIC HEALTH, BALTIMORE, injuries and is frequently features in print, these messages to key stakeholders, MD, USA online and broadcast media discussing patients, and parents.”

SOPHIE BAKRI on ophthalmology. She is a principal investigator on several multicenter clinical trials on novel drugs for retinal disease. PROFESSOR OF OPHTHALMOLOGY, She is editor-in-chief of the book “Mayo VITREORETINAL DISEASES Clinic on Vision and Eye Health,” and AND SURGERY, MAYO CLINIC, serves on the editorial boards of the ROCHESTER, MN, USA American Journal of Ophthalmology; Retina; Seminars in Ophthalmology; and Bakri considers her work in describing the OSLI Retina. She has served the Macula pharmacokinetics of intravitreal therapies Society as a meeting planning chair and as one of her biggest achievements an executive committee member, and Ophthalmologist Top 40 under 40 Power so far, and has hopes that her current is on the Retina Society’s nominating List in 2015, an Achievement Award from work on new pharmacotherapies for committee. She has also served as co- the AAO, an honor award from the ASRS retinal vascular diseases, such as AMD director of the Vision 2020 Initiative, and and inclusion among Becker’s 135 Leading and diabetic retinopathy, will result in is a board member and on the program Ophthalmologists in America list. more convenient and effective ways to committee of the American Society of treat patients. Retinal Specialists. One nominator described her thus: “Thought Bakri has published more than 150 peer- She has received several awards, leader, innovator, cutting-edge research and reviewed papers and 20 book chapters including being a member of The clinical care.”

www.theophthalmologist.com SUI CHIEN WONG of very few surgeons in the world with intravitreal ranibizumab to standard-of- expertise in using endoscopic vitreoretinal care retinal laser. surgery across a spectrum of adult and His mentors have described him as a CONSULTANT pediatric diseases, but particularly in gifted and outstanding surgeon whose OPHTHALMOLOGIST, GREAT acute retinopathy of prematurity (ROP) promise was evident as a Moorfields ORMOND STREET HOSPITAL retinal detachment. He is a member of a resident, when he was the best performing FOR CHILDREN; MOORFIELDS multidisciplinary pediatric vitreoretinal trainee in a surgical motion-tracking study EYE HOSPITAL; ROYAL FREE surgical team from GOSH, Moorfields published in Ophthalmology. HOSPITAL, LONDON, UK Eye Hospital and the Oxford Eye Hospital Since early 2014, he has worked closely offering a comprehensive specialist service with the Armenian EyeCare Project to Chien is among a handful of doctors to children and their families. train two leading Armenian surgeons in the world with a specialist practice Chien is active in clinical research to treat babies and young children with in pediatric vitreoretinal surgery and including OCT angiography imaging blinding retinal disease (including retinovascular diseases, in addition to his in Coats’ disease, familial exudative ROP) at the AECP national surgical adult vitreoretinal work. He treats and vitreoretinopathy and incontinentia center in Yerevan, including mentoring supports patients and their families with pigmenti. He is also the UK Chief via live telesurgery, in a partnership complex pediatric retinal disorders at Great Investigator and Moorfields Eye Hospital between GOSH and Children’s Hospital Ormond Street Hospital for Children Principal Investigator for the RAINBOW Los Angeles. (GOSH), Moorfields Eye Hospital phase III clinical trial, an international He has recently caught the ski bug with and the Royal Free Hospital. He is one randomized controlled trial comparing his two beautiful young boys. Feature 49

WILLIAM MAPHAM

REGISTRAR AT THE OPHTHALMOLOGY DEPARTMENT OF TYGERBERG HOSPITAL IN CAPE TOWN, SOUTH AFRICA; FOUNDER, VULA MOBILE

Mapham has served as the Vice Chair of the Rural Doctors Association of South Africa (RuDASA), and previously spent time in New York and Washington D.C. designing mobile phone applications for healthcare. He has published academic articles on the role of innovation and technology in improving healthcare delivery and has extensive experience in rural health care. He is the creator of Vula, a smartphone app that provides healthcare workers with basic ophthalmic diagnostic guidelines, and connects them with an ophthalmologist who can provide advice, respond to queries, and accept referrals in real time. Mapham’s three largest expenses are books, rare cheeses, and crowdfunding for experimental electronic gadgets.

YOSHI YONEKAWA His expertise has been recognized by numerous awards, including those from ADULT AND PEDIATRIC RETINA the Heed Ophthalmic Foundation, Ronald SURGEON, MASSACHUSETTS G. Michels Foundation, and the Retina EYE AND EAR INFIRMARY AND Society. Yonekawa has also contributed BOSTON CHILDREN’S HOSPITAL over 150 original papers, editorials, and OF HARVARD MEDICAL SCHOOL, book chapters to the field, and he serves MA, USA as Assistant Editor for the journal Retina, and as Deputy Editor of the Journal of Yonekawa directs the pediatric retina surgery VitreoRetinal Diseases. In his spare time, program at Boston Children’s Hospital, he enjoys spending time with his wife and and he is also adjunct faculty at Kyorin three boys. University in Tokyo, Japan. Yonekawa received his MD with honors from Weill A nominator listed the following reasons Cornell Medical College, completed his for his nomination: “Yonekawa is a rising ophthalmology residency at Harvard star in pediatric vitreoretinal surgery, he Medical School, and underwent fellowship has an incredible number of publications, training in adult and pediatric retina he is surgically extremely talented, as well surgery at Associated Retinal Consultants/ as a great teacher and mentor for residents William Beaumont Hospital, Michigan. and fellows.”

www.theophthalmologist.com 50 Feature

10. C. ANDRÉS BENATTI Latin-American web platform for ophthalmologists that offers news and CORNEA AND REFRACTIVE online ophthalmology educational SURGEON, ASSOCIATE courses. A former International Fellow PROFESSOR AND DIRECTOR OF at UC San Diego Shiley Eye Institute, TEACHING AND RESEARCH AT he is also a section editor for the AAO’s CLINICA DE OJOS CÓRDOBA, EyeWiki, and actively participates in CÓRDOBA, ARGENTINA different ophthalmology societies and educational platforms such as Cornea Benatti is a cornea and refractive surgeon Society, AAO, ISRS, and CAO. with extensive experience of LASIK, Benatti dedicates a lot of his time to corneal transplantation and managing philanthropic work. He regularly works patients with keratoconus – and yet with the Asociación para Evitar la is aged only 31 years. In 2015, he was Ceguera (APEC) en México, the largest identified by the Argentinian Council of eye hospital in Mexico City, and one Ophthalmology as one of the “prominent that’s dedicated to treating patients with young ophthalmologists of Argentina” and low incomes – an institute he previously earlier this year was featured as “surgeon of trained at. Benatti also supports, as an the month” by the International Society of external advisor, the Ojos para mi país Refractive Surgery – one of the youngest Foundation, a Mexican organization surgeons ever to have this honor. that aims to prevent blindness in the He is a co-founder of the international countryside, and is soon going to launch a corneal ectasia study group, Apectasias, non-profit organization, the Argentinian and OftalmoUniversity.com, the first Foundation Against Blindness.

9. CHELVIN SNG with Gold Medals conferred for being the best candidate in Glaucoma, Cataract and Refractive Surgery, Neuroophthalmology CONSULTANT and Pediatric Ophthalmology. OPHTHALMOLOGIST, NATIONAL A former Moorfields glaucoma UNIVERSITY HOSPITAL, fellow, she has gone on to be a pioneer SINGAPORE; ASSISTANT of MIGS surgery in Asia, being the first PROFESSOR AT THE NATIONAL Asian surgeon accredited to use several UNIVERSITY OF SINGAPORE; of the MIGS devices now available, HONORARY CONSULTANT AT including the iStent Inject and the MOORFIELDS EYE HOSPITAL, XEN-45 implant. With a plethora of peer- LONDON, UK reviewed publications and book chapters and positions on journal editorial advisory Sng graduated as the top medical student boards to her name – Chelvin was Lead from Gonville and Caius College in Guest Editor of a Special Edition on Cambridge University with triple First MIGS in the Journal of Ophthalmology Class Honors and distinctions, and has – and having secured over S$1.7 million in received several international awards research funding, she also finds the time from the ASCRS, AAO, ARVO and the to volunteer for medical missions to less Australian and New Zealand Glaucoma developed areas of South East Asia and India and Interest Group. She was also named and is a Visiting Consultant to the Chinese as the most outstanding candidate in her Foundation for Lifeline Express, where she year for the Ophthalmology Specialist lectures and provides clinical and surgical Accreditation Examination in Singapore, training to local Chinese ophthalmologists. 8. ANTHONY KHAWAJA Glaucoma Genetics Consortium (IGGC), the Consortium for Refractive Error and Myopia (CREAM) and the CLINICAL FELLOW, GLAUCOMA European Eye Epidemiology (E3) SERVICE, MOORFIELDS consortium, his primary research EYE HOSPITAL, LONDON, passion is discovering the biological UK; HONORARY CLINICAL processes underlying glaucoma by RESEARCH FELLOW AT THE examining genetic, epidemiological and UNIVERSITY OF CAMBRIDGE real-world data. He believes we have a AND UNIVERSITY COLLEGE duty to harness the potential knowledge LONDON, UK in routinely collected data to better the care of our patients. He has also won Khawaja completed the prestigious several prizes including the Moorfields Wellcome Trust PhD program at the Research Medal, the Royal College of University of Cambridge, winning the Ophthalmologists Foulds Trophy and Nick Day Prize for epidemiology, and the AAO Secretariat and Achievement he also won the Berkeley Fellowship awards. In 2016, he was awarded the Award supporting a research program at Moorfields Research Medal. Not much Harvard Medical School during which of a physical sportsman, Anthony’s team time he developed a novel algorithm activities at University were chess during for analysis of genome-wide data. He medical school and pool during his PhD. established and chaired the Young Ophthalmologists (YO) section of the One nominator said: “Multi-skilled in SOE and has been an active member epidemiology, genetics, statistical methods, of the AAO’s YO committee. The YO imaging and population research, brand is now growing globally and Anthony is a globally recognized and Anthony has helped establish YO groups sought after researcher. He is actively for other supranational societies, PAAO, collaborating with colleagues in Boston APAO, and MEACO. MA, Durham NC, Singapore and An active member of multiple Rotterdam, as well as around London, international consortia examining the Cambridge, and the wider UK, to make genetic and environmental epidemiology breakthrough advances in eye care. of eye diseases including the International Definitely ‘one to watch’.” The real ARGON experience

ARGON green the original

7. MARCUS ANG

CONSULTANT, CORNEA SERVICE, SNEC AND ASSISTANT PROFESSOR AT DUKE UNIVERSITY – NUS, SINGAPORE

A recent graduate of the Asia Pacific Academy of Ophthalmology’s Leadership Development Program, Ang is a widely published author with five book chapters and over 88 peer-reviewed Wavelength 514 nm publications to his name, the majority of which are first or PURE GREEN LASER LIGHT corresponding author in journals with impact factors >2.0 (he has an h-index of 20). His research work is mostly translational, such as studying prognostic factors to help improve outcomes following Battery powered. corneal transplantation, and this work has been recognized with several international awards. Indeed, Ang was the recipient of NO MORE CABLES the 2014 Singhealth Excellence Award – Distinguished Young Researcher, and he also holds several patents related to his specialist Remote foot switch. field. He has also undertaken voluntary Ophthalmology work in the community, leading volunteer missions to Asia and beyond NO MORE CABLES in his role as Director of Vision Projects at the Singaporean non- profit organization, Global Clinic, where he regularly organizes missions and travels to provide free cataract surgery in countries such as Indonesia, Thailand, Cambodia, India and Myanmar. www.arclaser.com Bessemerstr. 14 90411 Nuremberg [email protected] Germany  +49 911 217 79 -0

heOphthalmologist_2017_halPage.indd 3 03.04.2017 1:46:10 Feature 53

5. PEARSE KEANE

CONSULTANT OPHTHALMOLOGIST, MOORFIELDS EYE HOSPITAL, LONDON; NIHR CLINICIAN SCIENTIST AT INSTITUTE OF OPHTHALMOLOGY, UNIVERSITY COLLEGE LONDON, UK

Pearse is a retinal specialist at Moorfields Eye Hospital and a researcher at the University College London Institute of Ophthalmology. He specializes in the diagnosis and treatment of AMD and other complex macular diseases, and his research is focused on the application of new technologies to ophthalmology – from AI, to virtual reality, to advanced imaging. In 2016, Pearse was responsible for initiating the collaboration between 6. BOBECK MODJTAHEDI Toxicology,” a reviewer for multiple Moorfields and Google DeepMind, journals, and collaborates with leading with the aim of applying machine technology companies. His publications learning to OCT image analysis and OPHTHALMOLOGIST, SOUTHERN have helped shape the standard of in 2015, he was a awarded a “Clinician CALIFORNIA PERMANENTE care in multiple medical disciplines: Scientist” award from the National MEDICAL GROUP (SCPMG), he is a leading authority on imaging, Institute of Health Research (NIHR) BALDWIN PARK, CA, USA pharmacology, immunology, toxicology – the first ophthalmologist in the and new device development. His current UK to receive such an honor. He Modjtahedi is a vitreoretinal surgeon research aims to improve patient outcomes predicts that the combination of AI and Director of the Electrophysiology by analyzing complex “big data” to uncover with comprehensive, automated eye and Retinal Degeneration service at unique insights. He is additionally examination using binocular OCT will SCPMG, and also supervises their Eye working on improving healthcare access reinvent the eye examination for the Monitoring Center tele-ophthalmology internationally and has been described 21st Century. program. He completed his vitreoretinal as having “devised novel paradigms and surgery fellowship at the Massachusetts spearheaded ground-breaking projects Eye and Ear Infirmary where he was a that promise to fundamentally alter the Heed Fellow and received the “Fellow way healthcare is delivered.” of the Year” award. A recipient of some of the highest awards at each stage of his One nominator said: “At a young age he career, he was a Regent Scholar as well as a has already established himself as a leader recipient of University Medal, Leadership in the field. He has already made valuable Council Walter Rohrer Scholarship, contributions to the scientific literature and the University of California, Davis’ and is currently working on a number of “Outstanding Young Alumni Award.” large-scale projects that will help shape the He is the principal investigator for future of our field. His work has, and will several multicenter projects, the Associate continue to, tangibly effect the day-to-day Editor for “Cutaneous and Ocular management of patients.” 54 Feature

3. JOHN BERDAHL

PARTNER AT VANCE THOMPSON VISION, SIOUX FALLS, SD, USA; FOUNDER AND CEO OF EQUINOX, LLC

Berdahl is an ophthalmologist at Vance Thompson Vision specializing in cataract, refractive, corneal and glaucoma surgery. Berdahl has been chosen to take part in the Vision for Mars team, which is working closely with NASA and National Space Biomedical Research Institute to help solve vision problems during long-term space travel. He has a leadership role in EyeCare America, which provides free eye care to the underserved, and is Medical Director of the Dakota Lions Eye Bank. 4. BORIS STANZEL model. His recent activities have taken A MIGS pioneer, his current research that further, and include the use of efforts focus on understanding the intraoperative OCT during subretinal relationship between intracranial and CONSULTANT RETINA surgery for cell replacement therapy in intraocular pressure in glaucoma, fixing SPECIALIST AND DIRECTOR, large eye animal models, such as pigs. astigmatism after cataract surgery, and MACULA CENTRE, KNAPPSCHAFT Further, he and his colleagues at SNEC, sublingual anesthesia for eye surgery. EYE HOSPITAL SULZBACH, the NEI and Tampere University, Finland, His daily joy comes from wonderful SAARBRÜCKEN GERMANY; have successfully created a non-human relationships with his team-mates and GROUP LEADER, CLINICAL primate model platform for stem cell- partners at work, while his greatest joys STEM CELL TECHNOLOGY, based RPE replacement therapy evaluation come from any new water adventure with FRAUNHOFER INSTITUTE FOR – bringing this a step closer to clinical use. his wife and two children. BIOMEDICAL TECHNOLOGY, His next goal is to initiate a European cell SAARBRÜCKEN-SULZBACH, replacement therapy clinical trial. One nominator said, “He’s a creative thinker GERMANY; SCIENTIFIC about glaucoma and has led the discussion CONSULTANT, NATIONAL EYE One nominator said, “Boris is one of the most on glaucoma as a two-pressure disease. He’s INSTITUTE, BETHESDA, MD, USA gifted researchers around, and his work is doing very interesting work with goggles truly ground-breaking. I am sure his monkey that NASA may adopt as well. He is always Stanzel gained international renown for work evaluating the surgical macular coming up with interesting ideas but is very his transplantation of retinal pigment dynamics of cell replacement strategies in down to earth as well.” Another said, “Best epithelium into the subretinal space of macular degeneration will prove to be an fellow I ever trained, and I have trained rabbits – a first in a large-eyed animal important milestone in stem cell research.” many superstars.” and refractive surgery.” refractive and outcomes for and cataract delivery possible best the guide year. next due to is report that surgery cataract phacoemulsification manual vs. of femtosecond laser trial controlled randomized multicenter FACT NIHR the concept group research of the behind formation and for the responsible He was Guidelines. Commissioning Surgery RCOphth Cataract UK recent ofa member the and surgery on cataract reports Database Ophthalmology National of Ophthalmologists’ College Royal UK on the co-author a is Day nanophthalmos. and microphthalmos for definitions biometric accepted contemporarily the included work PhD His advances. surgery refractive and on cataract at major conferences speaker invited an is and papers 45 over peer-reviewed published he has and big data, of UCL Institute the and Hospital Ophthalmology. Eye at Moorfields Centre Research Biomedical NIHR the Lectureship Clinical NIHR an he undertook 2013, at PhD in earninga After ascientist. and asurgeon both is Day MOORFIELDS EYEHOSPITAL, LONDON,UK CORNEAL FELLOWANDLOCUMCONSULTANT, 2.ALEXDAY Day says, “My goal is high quality, robust evidence to evidence robust quality, high is goal “My says, Day and segment anterior the include interests research His Membrane FEELceps Feel thegrip F • • • • • • The newOertli for vitreoretinalprocedures membrane forceps For further information please contact [email protected] eel theprecision Precise 360°actuation Great responsiveness Short, absolutelinearstroke Anti-shredding finish Strong holdingforce oftissue Minimal activationforce ®

Ecknauer+Schoch ASW See The Future, Right Now.

YOU’ VE NEVER VISUALIZED YOUR PATHOLOGIES QUITE LIKE THIS.

Featuring next-generation visualization technologies and an innovative ocular-free design, the NGENUITY® 3D Visualization System establishes a platform for Digitally Assisted Vitreoretinal Surgery (DAVS).

11793-Alcon-NGENUITY-fullpage-The-Ophthalmologist.indd 1 02/11/2016 10:59 1. ALEX One nominator said: “Alex is an inventor of aqueous angiography, a ground-breaking HUANG technique that visualizes real-time aqueous humor outflow for improving the basic understanding of fluid flow in the eye. He is ASSISTANT PROFESSOR, Principal Investigator of several studies that DOHENY AND STEIN EYE have validated the used of this technology INSTITUTE, DEPARTMENT experimentally (post-mortem human eyes OF OPHTHALMOLOGY, and non-human primate live eyes), as well DAVID GEFFEN SCHOOL as in human patients. This new technology OF MEDICINE, UCLA, LOS offers great potential for enhancing and ANGELES, CA, USA individualizing glaucoma surgery.”

Today, Alex Huang is a glaucoma under Solomon Snyder in the Department the University of California, San Diego, specialist, a founding member of the of Neuroscience, Alex went on to research where Alex, with Robert, developed Doheny Eye Institute and UCLA atypical amino acids and their role in the basis for his research program that affiliation, and NIH-supported clinician melanocortin production, melanocortin examined the unstudied and potential post- scientist whose laboratory is developing behaviors, and retinal development – and it trabecular meshwork sources of aqueous an aqueous humor imaging technique, was this work that prompted him to pursue humor outflow resistance in the eye. This aqueous angiography, that should not only residency training in ophthalmology at led to an NIH Mentored Clinical Scientist help improve our basic understanding of Doheny Eye Institute Research Career Development Award, aqueous outflow, but also help optimize This is when his clinical and research and Alex is also funded by the American the efficacy of interventions that seek to interest in glaucoma really began. It started Glaucoma Society and Research to Prevent enhance natural outflow pathways – like with a basic science research endeavor with Blindness to develop aqueous angiography some MIGS devices. But Alex’s story James Tan at UCLA/Doheny that involved into a technique that can be used to visualize begins with neuroscience, not glaucoma. them identifying collagen and elastin outflow in a clinical setting. At home, Alex His undergraduate degree research as the biological origins of endogenous spends his time with his wife, Maggie, included work on axon guidance and trabecular meshwork autofluorescence in and two young sons, Ethan and Evan, hippocampal synaptic transmission. the human eye. After that, he became a most frequently building Legos probably As a MD/PhD candidate at The Johns Heed Ophthalmic Foundation-supported bought at the Legoland theme park in Hopkins University School of Medicine glaucoma fellow with Robert Weinreb at Carlsbad, California. For 70 years, Alcon has successfully discovered new ways to enhance sight and improve people’s lives. Our breakthrough innovations, strategic acquisitions and partnerships, and a deep-rooted commitment to partnering with and serving eye care professionals are what makes Alcon the global leader in eye care. We offer the most complete line of ophthalmic surgical devices, and are focused on continuously improving the options that exist today while also exploring new disease categories and treatment options.

ORA SYSTEM® Alcon Laboratories is incorporated. In 2017, together Alcon acquires WaveTec with 50 years of phaco, Alcon Vision, developer of the first celebrates its 70th anniversary – commercialized intra-operative 70 years of innovation and aberrometry system for cataract partnership with practitioners who surgery, in 2014. The ORA SYSTEM® connect us with patients and have allows surgeons to evaluate refractive been our partners in reimagining findings, refine IOL power, cylinder power eye care. and IOL alignment in real time to provide optimal refractive outcomes in cataract surgery. 1947 2014!

1994!

AcrySof® intraocular 2013! lens (IOL) 2008! CENTURION® Vison System Alcon receives FDA approval for the AcrySof® intraocular lens CONSTELLATION® Alcon introduces the (IOL), the first time a material had Vision System CENTURION® Vison System been developed specifically for with Active Fluidics, a next- an IOL. With almost 100 million Alcon introduces the generation phaco platform that eyes implanted since then, Alcon CONSTELLATION® automatically and continuously continues to make constant Vision System, an ophthalmic adapts to changing conditions innovations in IOL optics and microsurgical system indicated within the eye, provides delivery systems. for both anterior segment excellent anterior chamber and posterior segment stability during each step, and ophthalmic surgery. enhances fluidic management and surgical precision. “CyPass is a game- “Alcon Cataract changer for me and “NGENUITY gives me real benefits in the Refractive Suite my patients as a OR since it enhances innovations, such less invasive means my visualization as LenSx and ORA, of lowering IOP than of the back of help me enter the traditional glaucoma the eye without OR with a game surgery, with the having to bend plan that I can goal of lowering over a microscope, execute, which the patient’s while also helping allows me to dependence on minimize light deliver better topical glaucoma exposure to my patient outcomes.” medication.” patient’s eye.” Lawrence Quang Nguyen, MD George Williams, MD Woodard, MD

CYPASS® Micro-Stent device 2016! The CYPASS® Micro-Stent device, NGENUITY® 3D the first MIGS implantation into the Visualization System supraciliary space, receives FDA approval in July 2016 for use during 2017! Alcon launches the NGENUITY® cataract surgery. It is designed to 3D Visualization System, designed lower IOP by enhancing aqueous ACTIVEFOCUS™ Optical Design to enhance visualization of the outflow through one of the natural back of the eye for improved drainage pathways of the eye, with Alcon receives FDA approval surgeon experience. Retinal minimal tissue disruption, which allows in March 2017 for AcrySof® IQ surgeons can operate looking at a the excess fluid in the eye to drain. ReSTOR® +2.5 Multifocal Toric high-definition 3D screen, instead with ACTIVEFOCUS™ design for of bending their necks to look PANOPTIX® trifocal IOL uncompromised distance vision through a microscope. Alcon launches PANOPTIX® trifocal while correcting astigmatism IOL in some parts of the world in and presbyopia. 2015 and receives CE Mark status in November 2016 for PANOPTIX® Toric. 60  Sponsored Feature

view that chromatic aberrations protect from a. 2.0 b. Life in Full Color higher order aberrations (or vice versa), but the take-home message is that to get a true ** What does the assessment of understanding of lens performance, you 1.5 chromatic aberration in patients need to understand all the interactions, both bilaterally implanted with one monochromatic and chromatic, so you need 1.0 hydrophilic and one hydrophobic to measure both. IOL tell us about vision quality? Conventional aberrometers usually (D) LCA Susana Marcos has the answers. employ one wavelength, almost always 0.5 in the infrared spectrum. We have a We live in a polychromatic world, yet sophisticated system that combines adaptive most optical quality assessments optics, a supercontinuum laser source that 0.0 IOL hydrophobic G-free IOL Hydrophilic Young phakic eye Visible are monochromatic (with most being can operate at many different wavelengths (480–700 nm) performed with infrared light). Learning (from 480–950 nm), a Hartmann-Shack about color – and chromatic aberration – wavefront sensor to measure aberrations Figure 1. a. PodEye IOL: a combination of a is important, and I want to explain what this and defocus across those wavelengths, and a double-C loop platform and G-free material; means for IOL materials. psychophysical channel that we can illuminate b. A comparison of the longitudinal chromatic Longitudinal chromatic aberration (LCA) with the same laser light to measure best aberration profiles of two IOLs of the same occurs in the eye because of the wavelength focus across the visible light spectrum (480– design, but differing materials (hydrophobic and dependence of the refractive index of ocular 700 nm). We used this system to assess hydrophilic) and young phakic eyes (2). media. LCA makes short wavelengths focus both objective and psychophysical LCA in front of long wavelengths – in other words, across the visible spectrum (and perform mimic the natural lens – the values are very we are myopic for blue, and hypermetropic wavefront detection across the visible and close, and that’s true irrespective of whether for red. But when we replace the crystalline infrared spectra) in 18 eyes from 9 patients. we measure LCA psychophysically or with lens with an IOL, the chromatic dispersion These patients were bilaterally implanted the wavefront sensor, and it’s also irrespective of the ocular media changes – and this might with aspheric PhysIOL monofocal IOLs of the wavelength range examined. be different for different IOL materials. We of the same double C-loop design (Figure Remember, chromatic aberrations play a set out to characterize this. 1a), but made from different materials. major role in the quality of vision, and LCA One commonly performed IOL optics One eye received the G-free (patented by interacts with the eye’s natural aberrations assessment is the assessment of the lens’ PhysIOL) hydrophobic acrylic lens, the other, to improve the overall quality of vision. I modulation transfer function (MTF). In the hydrophilic acrylic lens. We obtained think it’s important to keep the LCA balance essence, MTF describes contrast as a function chromatic difference-of-focus curves from that’s present with the crystalline lens, and of spatial frequency, and you can think of it best-focus data at each wavelength, enabling I think that’s what we achieve with this a measure of optical contrast sensitivity: the us to calculate the LCA from the slope of hydrophobic G-free material. higher the MTF, the higher the contrast of linear regressions of those curves. the images projected on to the retina. If you Susana Marcos is Professor and Director of have a perfect, aberration-free eye and you What did we find and what does it mean? Visual Optics and Biophotonics Lab at the measure the MTF for red and green, then The eyes implanted with the hydrophobic Instituto de Óptica, Consejo Superior de both are actually very high, but the MTF for G-free IOL had a small but consistently Investigaciones Científicas, Madrid, Spain. blue is highly degraded. Why? Chromatic higher LCA than the eyes implanted with defocus – thanks to LCA. However, when the hydrophilic IOL; we found a statistically References you compare a real eye (with real aberrations) significant difference of 0.16 and 0.15 D 1. JS McLellan et al., “Imperfect optics may be the eye’s to a theoretical “perfect” eye, the red and when measured by psychophysical and defence against chromatic blur”, Nature, 417, green MTFs are much poorer, thanks to the wavefront-sensing methods, respectively, in 174–176 (2012). PMID: 12000960. effects of monochromatic aberrations, but the visible light wavelength range. And things 2. M Vinas et al., “In vivo subjective and objective the MTF is much better with blue (1). Again, get interesting when we start to compare longitudinal chromatic aberration after bilateral why? The chromatic and monochromatic these results with those of young phakic implantation of the same design of hydrophobic and aberrations have actually interacted to eyes – see Figure 1b. In terms of LCA, the hydrophilic intraocular lenses”, J Cataract Refract Surg. improve the blue MTF. You could take the hydrophobic G-free material appears to 41, 2115– 2224 (2015). PMID: 26703287.

www.physiol.eu In Practice

Surgical Procedures Diagnosis New Drugs

62–65 A New Carpet Over Broken Tiles Facing an eye with multiple, deep radial keratotomy cuts? Arun Gulani describes how the right mindset and technique can make all the difference. 62 In Practice

A New Carpet Over Broken Tiles

Don’t be disheartened by the scars or the number, pattern or irregularity of radial keratotomy cuts – achieving excellent vision in these eyes is possible using refraction- based, laser corneoplastique

By Arun Gulani and Aaishwariya Gulani

Radial keratotomy (RK) was a very popular technique in the eighties. A series of radial, deep corneal incisions (Figures 1 and 2) flattened the cornea – Figure 1. An array of radial keratotomy patterns and incisions – all of which can be addressed using and corrected myopia. But although it laser corneoplastique. served thousands of patients well at the time, it also resulted in hyperopic shifts to their doctors with vision issues – it’s my laser corneoplastique approach (1), over time, creating irregular corneas with essentially a refractive epidemic. But I which can not only correct the full range long-term visual instability. Now, there believe it’s possible to “turn back the of refractive errors that can result from are thousands of patients worldwide who clock” with the right approach. RK but also its associated pathologies. underwent RK and are now presenting Let’s review the “inside-out” and Tackling the refractive epidemic head on “outside-in” lens implant-based The list of potential problems when combination protocols. At a Glance dealing with post-RK corneas can be “Outside-in” is an approach for • Many prior radial keratotomy long: the size and placement of the situations when corneal topography patients are now presenting to incisions and scarring can leave you cannot be measured; for example, in ophthalmologists with vision dealing with a particularly fragile cases of corneal scarring, post-RK problems caused by irregular cornea. The next problem is biometry: irregular ametropia, or post-LASIK ametropia, including hyperopic taking accurate measurements in these ectasia. The cornea is first made shift over time eyes can be particularly challenging measurable using procedures like Intacs, • These cases can seem daunting, – and predicting outcomes is also lamellar keratoplasty or corneal collagen but it’s possible to produce great difficult. It’s important to always begin crosslinking, and then cataract surgery outcomes with the right approach surgery with the right mindset: don’t be is performed once accurate biometry for vision correction intimidated by the number or pattern of and IOL calculations can be made. The • LASIK is one possible approach RK cuts you see in your patient’s cornea “inside-out” approach is used when the – but it may cause more problems (see Figure 1). Instead, go into surgery cornea is measurable but still needs than it solves, and could further with the belief that despite the cuts, refractive correction – in these cases, the destabilize the cornea it’s possible for your patient to achieve cataract surgery is performed first, with • Laser corneoplastique is an advanced unaided emmetropia and 20/20 vision. the aim of correcting residual refractive form of surface laser surgery There is a whole spectrum of corneal error afterwards using ablation. involving manual epithelium and lenticular techniques that can be Imagine the post-RK cornea as a sheet removal, which helps the cornea heal, used to rehabilitate vision, but I shall of well-adhered but broken tiles. The and decreases surface irregularities restrict the discussion here to the use of returning epithelium following this laser In Practice 63

surface ablation approach not only covers and heals the cornea but also decreases surface irregularities and instability – over and above the refractive correction achieved with the excimer laser alone. Anecdotally, I have also noted this procedure results in greater vision stability. After over two decades of correcting virtually every variety of post-RK cornea and their associated pathologies to give these patients emmetropic vision, I believe this approach produces the best possible outcomes. Another option for post-RK corneas is, of course, regular LASIK surgery – but this should be avoided. In my view, LASIK on RK corneas is not the best idea, both anatomically and physiologically: it horizontally destabilizes a structure that is already vertically compromised. Think of a cake cut into eight pieces, nicely held on a platter. Now, take a knife and cut through all eight pieces with a single horizontal swipe – you are highly likely to dislodge some pieces. By performing LASIK on these eyes, you place the patient at a high risk of tissue displacement, refractive fluctuations, corneal ectasia, irregular astigmatism, epithelial ingrowth at flap incision intersections, along with dry eye and tear film instability. Just because the approach works in some cases, doesn’t mean it’s the best approach here!

“There are thousands of patients worldwide who underwent RK who are now presenting to their Corneal Hysteresis: doctors with vision issues.” His sight depends

Delicate but decisive on your conﬁ dence. Laser corneoplastique is performed as a no-flap, no-cut, surface ablation technique broadly similar to conceptual Ocular Response Analyzer® G3 photorefractive keratectomy (PRK) surgery, but with advanced protocol and manual epithelium removal. The epithelium Corneal Hysteresis is a superior predictor should not be removed with alcohol or toxic chemicals, of glaucoma progression. CPT code 92145 but instead with a blunt, modified diamond-dusted spatula – the Gulani LASIK spatula. I have classified this process Learn more at reichert.com/glaucomaconﬁ dence into centripetal (removal from the periphery to the center) and centrifugal (removal from the center to the periphery) techniques. I use a centripetal technique in most post-RK cases with no additional corneal issues like prior LASIK surgery, and I find that a centrifugal technique is more applicable in

Ocular Response Analyzer is a registered trademark of Reichert, Inc. · www.reichert.com

ORA-G3-Confidence-Oph'gist-half-vert-0417.indd 1 3/31/17 1:47 PM 64 In Practice

– it reveals the underlying cornea and the work of the previous surgeon, and no number of topographies or OCT images can give you this information. The most important step of all comes next: refraction-based laser corneoplastique. Your refraction through these corneas has to be very accurate and you must check it repeatedly during preoperative visits. Using the 193 nm argon fluoride excimer laser at 120 MJ/cm2 at a modified pulse frequency, I proceed with ablation, followed by Mitomycin C 0.02% washed by BSS at completion for 20 seconds. In my experience – and in all cases – the patient will begin to see more clearly right there under your laser. Place a bandage contact Figure 2. An illustration of RK in eyes that have undergone multiple surgeries, including lens on this cornea, and the procedure pseudophakic and phakic IOL implantation. is completed.

“Refraction is a must and accuracy is absolutely paramount.”

Why should you choose a surface ablation technique, such as laser corneoplastique? In essence, you’re taking away all the negatives of incisional keratorefractive surgery (including regular LASIK), so that you are Figure 3. Corneal scars with RK cleared in minutes to plan for inside-out or outside-in cataract surgery. sculpting with a sub-micron precision laser to get the shape you want. You’re cases where there are other associated but decisive and fast – this will lead also able to correct the entire range corneal issues, such as LASIK flaps, to less irregularity and a lower chance of refractive errors, address irregular scars, or very unstable corneas with deep of creating false planes including the astigmatism, and correct associated intersecting RK cuts. It’s important to opening of RK incisions. corneal scars. bear in mind how fragile these corneas Epithelium removal is the most As I always say: refraction is a must are – your movements should be gentle, important physical step in these cases and accuracy is absolutely paramount In Practice 65

– in fact, it is the single most important defining factor of your success. The number of cuts, the pattern, or how “horrible” they look doesn’t matter at all. A medication protocol of antibiotic and anti-inflammatory drops for two weeks and steroid drops on a taper from 4 to 1 per day over four weeks is followed. I remove the bandage contact lens by day five, and the majority of patients had epithelial closure by this time. No patients reported any pain, even when questioned, underscoring the fact that the surgery is comfortable for patients, and provides vision recovery and results that even these highly demanding patients find satisfactory.

A winning combination Laser corneoplastique in post-RK eyes can also be combined with cataract surgery, as many of these patients are now of the age where cataract surgery might be indicated, and clearing the cornea of scars or irregular refractive errors with this procedure, combined with cataract removal should lead to the best possible postsurgical visual outcomes (Figure 3). Excimer laser use – as an advanced version of PRK – in laser corneoplastique mode is a safe, effective and predictable technique to correct refractive errors in post-RK eyes. Instead of weakening an already weakened cornea, the returning epithelium decreases fluctuations, improves anterior corneal smoothness and shape, which, in turn, makes the RK cuts (no matter the number) less relevant visually. It’s like placing a new carpet over broken tiles...

Arun Gulani is the founding Director and Chief Surgeon of the Gulani Vision Institute in Jacksonville, Florida, USA and has specialized in over 48 vision corrective techniques including advanced LASIK, premium cataract and custom corneal surgery. An award- winning inventor of numerous surgical instruments and techniques, Gulani is a widely published author and The Most Advanced international instructor to eye surgeons worldwide. Aaishwariya ® Gulani, is a pre-med undergraduate at Wharton School of Phoroptor Ever Built. Business at the University Pennsylvania. Phoroptor® VRx Digital Refraction System Arun Gulani is a consultant for Ocular Therapeutix, Oculus and MARCO. Aaishwariya Gulani reports no Thinnest & most compact. Incredibly fast. conflicts of interest. Ultra-quiet. Effortless integration. Made in USA.

A video of the laser corneoplastique technique is available Learn more at reichert.com/vrx online at: https://youtu.be/OmPtGwT4eQs.

Reference 1. AC Gulani, “Corneoplastique™: art of vision surgery”, Indian J Ophthalmol, 62, 3–11 (2007). PMID: 24492495.

Ocular Response Analyzer is a registered trademark of Reichert, Inc. · www.reichert.com

Phoroptor-VRx-Oph'gist-half-vert-0417.indd 1 3/31/17 1:47 PM How to Never Be Bored

Sitting Down With... Farhad Hafezi, Professor, University of Geneva; Clinical Professor of Ophthalmology, Keck School of Medicine, University of Southern California (USC) Los Angeles, USA; Chief Medical Officer, The ELZA Institute, Zurich, Switzerland. Sitting Down With  67

A rising star in retinal degeneration – both professionally and personally. Of in all honesty, the simplest and most research in the 1990s; a leading light course, if there is a potential conflict of important motivation is to satisfy my in refractive surgery a decade later – interest (when I’m involved in spinoff own curiosity – it’s just lovely to be able why the big switch? companies, for example), I always lay to play in this huge sandpit of research The change was inspired by my need all of my cards out very openly on the and science. to be fascinated by what I’m doing – table. It’s an approach that’s gained me coupled with the incredible enthusiasm respect in the field over the years – I Any particular career highlights? of Theo Seiler. Shortly before I finished always tell it how it is, whether that’s Professionally, the most exciting moment my residency in Zurich, Theo became to my advantage or disadvantage, and was when I was published on the cover of chairman. Until then, I’d experienced people really respond to that. Nature Medicine, exactly 20 years ago. relatively little mentorship. He passed Back then, we connected to the Internet by on his love for the cornea, and I decided What does a typical week look like? dial-up modem, and I remember coming to follow it. Some people told me it I usually see patients from 8 am– home late one Friday night, hoping to was a foolish thing to do, especially as 12 pm and 1–5 pm, five days a week. At view the Nature Medicine website; slowly I already had around 20–25 papers on noon, I eat and try to do some work on – almost pixel-by-pixel – I saw the cover retina published, including a first-author manuscripts and talks and I try to leave appear... We were on it and I remember cover story in Nature Medicine and a two or three hours free a week over lunch yelling with joy! I joke that it’s a bit like Nature Genetics co-authorship. At the to speak to my basic research team. I the career of Orson Welles – you start time it may have seemed unwise, but aim to be home by 6 pm, because it’s out with this huge thing (Citizen Kane), looking back, I definitely don’t regret it. extremely important to Nikki and me and then for the rest of your career you’re that we spend time with our (still little) trying to get that again! Research, patients, and faculty children and eat dinner together. At positions... How do you keep all your 8.30 pm when the children go to bed, plates spinning? we get back to work. The short answer is that I couldn’t possibly do it alone. A good team is What do you hope to achieve over the “It’s just lovely essential – and the best teammate I next year? have found is my wife, Nikki, who I’m anticipating completing the PACK- to be able to is also my best friend and partner in CXL trial, and getting a CE mark for the research and business. An idea alone is C-Eye device for crosslinking at the slit play in this huge only part of the battle. I realized that lamp and launching it commercially. I’d I had two choices: I could keep my also love to take a three-week vacation sandpit of research ideas to myself and accept that they with my wife and kids... Knowing how might never be realized, or I could our lives usually go, these things will and science.” share them and become a collaborator probably all happen simultaneously! working with other sites to implement them. We run a small team, and we have What drives you – and how do you more ideas than we have manpower and measure success? What would your career epitaph be? hours in the day. Besides our in-house I believe peer recognition is hugely You could be the greatest researcher on research, we decided to identify bright important, as is advancing the field. earth, but if you are an arrogant, unpleasant young researchers – people who can And I derive a deep satisfaction from person, nobody will remember you. So I get involved, pick up our ideas and run being able to help predominantly young would like to be remembered as a good, with them. We help with aspects like people with keratoconus. Money has approachable person who helped others protocols and ethical approvals, but they never been a motivator for me. If it was, advance – especially the younger generation. execute the study. I’d have become a banker or something Of course, it would also be great to be – you need to work with money to make remembered for advancing the field! If I How do you deal with any potential money. Balancing work and life would had to pick just one sentence, I’d like to conflicts of interest? also be a great success, and I’m still paraphrase the Pet Shop Boys – “I was never Honesty is extremely important to me looking for that magic formula. But boring, because I was never being bored.”

www.theophthalmologist.com Product Name: TAPTIQOM® 15 micrograms/ml + 5 mg/ml eye drops, solution in single-dose container. Composition: One drop (about 30 µl) contains about 0.45 micrograms of taflupost and 0.15 mg of timolol. One single-dose container (0.3 ml) of eye drops contains 4.5 micrograms of taflupost and 1.5 mg of timolol. Please refer to the Summary of Product Characteristics (SmPC) for a full list of excipients. Indication: Reduction of intraocular pressure in adult patients with open angle glaucoma or ocular hypertension who are insufficientlyresponsive to topical monotherapy with beta-blockers or prostaglandin analogues and require a combination therapy, and who would benefitfrom preservative free eye drops. Posology and method of administration: Recommended dose is one drop in the conjunctival sac of the affected eye(s) once daily. Not to exceed one drop per day in the affected eye. Not recommended in children or adolescents (under the age of 18). In renal or hepatic impairment use with caution. To reduce systemic absorption, patients should be advised to use nasolacrimal occlusion or close the eyelids for 2 minutes after instillation. Excess solution should be wiped away to reduce the risk of darkening of eyelid skin. If more than one ophthalmic product is used, fiveminutes should separate their administration. Contact lenses should be removed before instillation. Contraindications: Hypersensitivity to the active substances or to any of the excipients. Reactive airway disease including bronchial asthma, or a history of bronchial asthma, severe chronic obstructive pulmonary disease. Sinus bradycardia, sick sinus syndrome, including sino-atrial block, second or third degree atrioventricular block not controlled with THE NEXT STEP pace-maker. Overt cardiac failure, cardiogenic shock. Warnings and precautions: Before initiating treatment, patients should be informed of the possibility of eyelash growth, darkening of the eyelid skin and increased iris pigmentation related to taflupost. These changes may be FOR POWERFUL permanent, and lead to differences in appearance between the eyes if only one eye is treated. Similar cardiovascular, pulmonary and other adverse reactions as seen with systemic beta-adrenergic blocking agents may occur. The incidence of systemic adverse reactions after topical IOP LOWERING ophthalmic administration is lower than with systemic administration. Caution should be exercised when prescribing TAPTIQOM® to patients with cardiac or severe peripheral vascular disorders eg Raynaud’s disease or syndrome. Use with caution in patients with mild/moderate 1 COPD and in patients subject to spontaneous hypoglycaemia or labile • Up to 40% vs baseline diabetes. Beta-blockers may mask signs of hyperthyroidism and block systemic beta-agonist effects such as those of adrenaline. Anaesthetists should be informed when a patient is receiving timolol. Patients with a • Low level of history of severe anaphylactic reaction may be more reactive to repeated 2 challenge with such allergens and be unresponsive to the usual doses hyperaemia (7%) of adrenaline used to treat anaphylactic reactions. The known effects of systemic beta blockers may be potentiated when TAPTIQOM ® is given 2 concomitantly. The use of two topical beta-blockers is not recommended. • One drop once daily Patients with corneal disease should be treated with caution as ophthalmic beta-blockers may induce dry eyes. When timolol is used to reduce elevated intraocular pressure in angle-closure glaucoma, always use a miotic. Caution is recommended when using taflupost in aphakic patients, pseudophakic patients with torn posterior lens capsule or anterior chamber lenses, and in patients with known risk factors for cystoid macular oedema or iritis/uveitis. Please see the SmPC for further information. Interactions with other medicinal products: Potential for hypotension / marked bradycardia when administered with oral calcium channel blockers, beta-adrenergic blockers, anti-arrhythmics, digitalis glycosides, parasympathomimetics and guanethedine. Please refer to the SmPC. Pregnancy: Do not use in women of childbearing age/potential unless adequate contraceptive measures are in place. Breast-feeding: It is not recommended to breast-feed if treatment with TAPTIQOM® is required. Driving and using machines: If transient blurred vision occurs on instillation, the patient should not drive or use machines until clear vision returns. Undesirable effects: Conjunctival/ocular hyperaemia occurred in approximately 7% of patients participating in clinical studies with TAPTIQOM®. Other common side effects include: eye pruritus, eye pain, change of eyelashes (increased length, thickness and number of lashes), eyelash discolouration, eye irritation, foreign body sensation, blurred vision, photophobia. Adverse reactions that have been seen with either of the active substances (taflupost or timolol) and may potentially occur also with TAPTIQOM® include: increased iris pigmentation, anterior chamber cells/flae, iritis/uveitis, deepening of eyelid sulcus, hypertrichosis of eyelid, exacerbation of asthma, dyspnea, allergy, angioedema, urticaria, anaphylaxis, hypoglycaemia, syncope, ptosis, bradycardia, chest pain, palpitations, oedema, cardiac arrest, heart block, AV block, cardiac failure. Please also see the SmPC. Overdose: Treatment should be symptomatic and supportive. Special precautions for storage: Store in a refrigerator (2°C - 8°C). After opening the foil pouch keep the single-dose containers in the original pouch and do not store above 25°C. Discard open single- dose containers with any remaining solution immediately after use. Package quantities and price: 30 x 0.3ml single-dose containers £14.50. Marketing authorisation holder: Santen Oy, Niittyhaankatu 20, 33720 Tampere, Finland. Marketing authorisation number: PA 0879/003/001. Date of authorisation: 28/11/2014. Legal Category: POM. Prescribing information job code: STN 0418 TAP 00001a Date of prescribing information: 14/04/2016.

Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard. Adverse events should also be reported to Santen UK Limited (Email: [email protected] or telephone: 0345 075 4863).

TAPTIQOM is a registered trademark of Santen Pharmaceuticals Co., Ltd. References: 1.Holló G et al. Fixed-Dose Combination of Tafluprost and Timolol in the Treatment of Open-Angle Glaucoma and Ocular Hypertension: Comparison with Other Fixed-Combination Products. Adv Ther. 2014; 31: 932-944 2.Taptiqom SPC, last changed October 2014

Job code: STN 0918 TAP 00038 Date of preparation: September 2016