robert machemer: a pioneer in vision duke eye center stephen j. ryan april 30, 2010 durham, nc

ROBERT MACHEMER:

A PIONEER IN VISION

Duke Eye Center

Stephen J. RyanApril 30, 2010Durham, NC

Robert MachemerVisionaryCreativeFather of vitrectomyCourage – first casesEngineering and

MedicineBascom Palmer and DukeTeacher, colleague, and

friend

Creativity vs. Problem Solving

NovelSimpleElegantEffective

Generative

Robert MachemerOpened the Vitreous

SpaceVitreo Retinal

SurgeonsEndo Surgery

Intraocular and Other

Pathogenesis of R.D.

Vitreous Surgery

Opened whole new fieldEducated many trainees Future

LeadersGenerous with his time and

encouragementStimulated ideasEncouraged Critical Thinking

Research Influenced by Robert Machemer

Vitreous Surgery – Clinical and ResearchPathogenesis of Retinal detachment

RhegmatogenousTraction

Translational research patientsMany other areas

ClinicalResearch

ClinicalObservations

AnimalResearch

Clinical Practice

LaboratoryResearch

Penetrating Ocular InjuriesTrauma model Penetrating injuries –

more detachments than blunt injuries

Penetrating injuries alone no R.D.

Blood alone no R.D.Injury + Blood R.D.

TRACTION RETINAL DETACHMENTWOUND HEALING

Clinical ManagementRhegmatogenous R.D.After penetrating injury, two rows of 360

extensive cryotherapy to prevent RRDHuge additional inflammatory stimulus

After Vitrectomy – different RxVitrectomy Remove stimulus to

inflammation and wound repair

Final Common Pathway

Breakdown of Blood Retinal Barrier

AbnormalVitreous

MigrationProliferation

Contraction

Traction Detachment

Trauma PVR PDR

COMMERCIALIZATION

CLINICALRESEARCH

BASIC RESEARCH

TRANSLATIONALRESEARCH

IDEA

PATIENT

CLINICIAN

Robert MachemerVisionaryCreativeFather of vitrectomyBascom Palmer and DukeTeacher, colleague, and

friend

PIONEER