EEF Sight + Sound: Spring 2017

News for Supporters and Friends

2017 SPRING EDITION

Department of Otolaryngology Establishes a Survivorship Clinic

by Jonas Johnson, MD & Carrie Fogel

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he Commission on Cancer as well as the Institute of Medicine have encouraged doctors treating patients for cancer to provide more comprehensive information on their treatment to both patients and their physician. This should include a printed plan for continuing survivorship.

Survivorship has been described as the period in a person’s life after they have been diagnosed with cancer. The first stage of survivorship, of course, is treatment. After treatment; however, life does go on. In terms of patients treated for cancer of the head and neck, the first period is recovery from the treatment. Surgery causes pain, swelling, and some deformity. Chemotherapy and irradiation therapy cause other, sometimes severe, side effects, and with the increase of cancers of the head and neck associated with

In This Issue New Salvitti Chair Established

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Solving the Puzzle of Head and Neck Cancer

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Meet Our Scientists

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Fighting Aging and Dementia with Hearing

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Preserving Children’s Vision in Our Community

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CREATing New Pathways to Improve Surgery

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New Technology to Improve Outcomes for Glaucoma Surgery 7

The multidisciplinary survivorship team includes, back row: Jonas Johnson, MD.; Karen Losego, PT, DPT, CLT-LANA; Antonia Teruel Castellon, DDS, MS, PhD; Tamara Wasserman Wincko, MS, CCC-SLP; and Debra Pickford, BSN, RN. Front row: Susan Calderbank, DMD; Lori Zitelli, AuD; and Marci Lee Nilsen, PhD, RN human papillomavirus (HPV), we expect that more patients will need survivorship care than ever before.

Following recovery from the acute side effects, almost every patient finds that their body has been changed forever. Common problems include a change in the saliva, excessive thick mucus, loss of taste and eventually loss of teeth. Other problems can develop such as stiffness in the neck and shoulders and, of course, difficulty swallowing. Less common, but very important, challenges include progressive loss of hearing (the causes vary) and the onset of anxiety and depression.

These challenges can effect quality of life

and, in some situations, lead to a significantly lower quality of life.

The UPMC Survivorship Clinic was established to better meet the needs of head and neck cancer survivors by eliminating fragmented post-treatment care. The Survivorship Clinic is a multi-disciplinary collaboration of nurses, doctors, swallowing therapists, dental medicine, and other healthcare providers, including physical and mental health therapies.

Patients are comprehensively surveyed regarding their needs, in an effort to identify potential areas with which we can help.

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New Salvitti Chair Established:

Dr. E. Ronald Salvitti Doesn’t Sit on the Sidelines When it Comes to Philanthropy, Caring for his Patients, or Showing Love for His Family

by Heather Chronis and Lawton Snyder

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hilanthropy begins at home for E. Ronald Salvitti, MD, one of Western Pennsylvania’s most prominent ophthalmologists.

Founder of the Southwestern Pennsylvania Eye Center, a bustling Washington, Pennsylvania medical practice, Dr. Salvitti has long donated to higher education institutions and projects that are important to both him and his family.

the ticket to make sure that we succeeded in life, and I have instilled that same belief in my children, and now my grandchildren,” he says.

In 2006, Dr. Salvitti supported the University of Pittsburgh’s Department of Ophthalmology with the E. Ronald Salvitti, MD Chair in Ophthalmology Research, which is currently held by Jeffrey Gross, PhD, Director of the Louis J. Fox Center for Vision Restoration.

“Regenerative medicine is very interesting to me. Daily, I see the problems associated with the progression of macular degeneration related to aging in patients. Dr. Gross’ research on regenerative medicine has the potential to transform the lives of these patients,” states Dr. Salvitti. Supporting causes that have directly impacted Dr. Salvitti’s life and profession are the touchstone of his philanthropic endeavors.

He continues to attend many Department of Ophthalmology and University of Pittsburgh educational events and is encouraged by the international direction that the Department of Ophthalmology will take in the upcoming years under the direction of Chairman, JoséAlain Sahel, MD. Dr. Salvitti, who was on the executive search committee that helped to recruit Dr. Sahel from Paris, understood that Dr. Sahel’s vision would require greater funding than previous efforts.

In 1994, Dr. Salvitti’s interest in philanthropy led him to establish the Salvitti Family Foundation. The Family Foundation has allowed him to bring a principled, systematic and disciplined approach to giving. The dual primary purposes of the foundation are to support higher education and local charities.

Over the last twenty years, the Salvitti Family Foundation has made multiple major gifts to academic institutions that have impacted Dr. Salvitti’s life, including W & J College, Temple University Medical School, the University of Pittsburgh and Seton Hill University. Many of these gifts support students directly by offering significant scholarship opportunities to put the benefits of higher education into deserving hands.

Consequently, this past December, Dr. Salvitti renewed his commitment to the Department by endowing the Jennifer Salvitti Davis, MD Chair in Ophthalmology Research to honor his

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[Dr. Salvitti’s] greatest wish in philanthropy is now to inspire others to support causes that are meaningful to them.

E. Ronald Salvitti, MD, and his daughter, Jennifer Salvitti Davis, MD daughter, an ophthalmologist and a member of his practice. “I have watched my father develop his strong sense of philanthropy my entire life and I am honored to have him involve me in such a worthwhile effort with this gift. I am even more honored to have the gift of working with him every day,” says Dr. Davis.

“I have always believed that philanthropy was important, and the needs that I saw closest to me were those that inspired me. I began at a young age donating small amounts of money to my church,” says Dr. Salvitti. Many years later, Dr. Salvitti underwrote essential repairs and major renovations to his church. His first foray into supporting colleges and universities on a large scale came when he helped fund the seed money for a science center at his alma mater, Washington & Jefferson College.

Dr. Salvitti, the son of a coal miner, is the first person in his family to graduate from both high school and college. “It all came down to good parenting. My parents felt that education was

Dr. Salvitti’s generosity of endowing two chairs sets a new bar in philanthropy at both the Department of Ophthalmology and the University of Pittsburgh. This gift comes at the perfect juncture of four of the major passions in Dr. Salvitti’s life: philanthropy, education, ophthalmology, and, most importantly, his love for his family. His greatest wish in philanthropy is now to inspire others to support causes that are meaningful to them. On giving, Dr. Salvitti says, “If there is something that has been important in your life, then support it; it’s really that simple. This is the greatest example that I can set.”

Solving the Puzzle of Head and Neck Cancer with Personalized Medicine

by Heather Chronis

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obert Ferris, MD, PhD, has always had an interest in diseases that are difficult to conquer, both in the clinical arena and in the research laboratory. As a medical student at Johns Hopkins University in the 1990s, Dr. Ferris was intently studying HIV and trying to find answers to the virus’s unique features.

“I have always been interested in diseases that are a like a puzzle. How do you move the pieces around to put the whole picture together and answer the question?” states Dr. Ferris. However, a new medical puzzle emerged while he was still in school — human papilloma virus (HPV) and, specifically, its role in cancer of the head and neck.

It had been thought for years that smoking and drinking were the greatest precursors to head and neck cancer. The team at Johns Hopkins began to see an uptick in head and neck cancer patients that also tested positive for HPV. While the numbers of patients with HPV were increasing, this was also the patient group that had better outcomes for overall survival with head and neck cancer.

Intrigued by this new piece of the puzzle in

What Dr. Ferris...and others have discovered is that while some patients might all have the same type of cancer, each might have a tumor that responds totally differently to treatment; therefore, following one standard protocol is not effective in saving lives or even maintaining a good quality of life.

“I have always been interested in diseases that are a like a puzzle. How do you move the pieces around to put the whole picture together and answer the question?” head and neck cancer, Dr. Ferris turned his focus to discovering more about this rapidly emerging new factor.

Cancer has traditionally been treated with four different options: surgery, chemotherapy, radiation and, now, immunotherapy.

Physicians were cautiously optimistic with the potential outcomes of each of the four options, but there was always a variability factor — why did some patients recover, while others with the same type of cancer did not? Immunotherapy, a treatment designed to boost the body’s natural defenses to fight cancer, uses substances either made by the body or in a laboratory to improve or restore immune system function. It can stop or slow the growth of cancer cells, along with preventing the cancer from spreading to other parts of the body. In addition, it can assist the immune system to better destroy cancer cells. Immunotherapy is non-invasive and has the least amount of side effects of the four cancer treatment options. Testing positive for HPV adds another factor into the immunotherapy treatment plan. For example, the HPV vaccine has shown promise in combination with cancer drugs in head and neck cancer patients that test positive for the virus.

As Vice Chairman of the Department of Otolaryngology at the University of Pittsburgh School of Medicine and Director of the Marion S. Mosites Initiative for Personalized Medicine, Dr. Ferris is on the forefront of immunotherapy research that offers hope for head and neck cancer patients. What Dr. Ferris, who is currently involved in three

Robert Ferris, MD, PhD awarded with the UPMC Chair in Advanced Oncologic Head & Neck Surgery during the Provost’s Inaugural Lecture, University of Pittsburgh, January 11, 2016. clinical trials, and others have discovered is that while some patients might all have the same type of cancer, each might have a tumor that responds totally differently to treatment; therefore, following one standard protocol is not effective in saving lives or even maintaining a good quality of life.

The Mosites Initiative has provided the funding necessary for specific immunotherapy research, which can often have unpredictable outcomes. While government and corporate funding are important to research efforts, traditionally they require a logical outcome from the research. With cancer research, the outcomes are often illogical. “Both positive and negative outcomes of research are good things. Obviously, we want positive outcomes that help the patient; but negative outcomes send us in a different direction. This is why private philanthropy is critical, as it allows us to find out the positive and the negative of a treatment with the end goal of better patient outcomes,” states Dr. Ferris.

To learn more about Dr. Ferris’ research, please contact the Eye & Ear Foundation at 412-383-8749 or heather@eyeandear.org.

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We would like to welcome Ethan Rossi, PhD and Leah Byrne, PhD to the University of Pittsburgh.

They are among the first scientists recruited by Dr. José-Alain Sahel, Chairman of Ophthalmology, to join the department and each are working to understand diseases of the eye in two different, but equally groundbreaking ways.

Ethan Rossi, PhD, Assistant Professor of Ophthalmology

by Carrie Fogel

Ethan Rossi, PhD came to Pittsburgh in August as Dr. José-Alain Sahel’s first recruit to the Department of Ophthalmology. Dr. Rossi has a background in Vision Science, and his work uses a cutting-edge technology, known as Adaptive Optics (AO), to image the living eye to detect retinal diseases with more detail and precision than any other technique currently in use. This advanced imaging technology was first developed and applied to eye the by Dr. Rossi’s postdoctoral mentor David Williams, at the University of Rochester. By using AO, Dr. Rossi is able to see changes in the eye at a cellular level, thus giving him and, now, our physicians the ability to detect microscopic changes in the structure of the eye and the onset of ocular disease earlier than ever before. In using the Adaptive Optics technology, Dr. Rossi aims to revolutionize how we understand disease patterns and provide physicians the opportunity to intervene at an earlier state of disease, like age-related macular degeneration (AMD) and glaucoma, to prevent vision loss.

Dr. Rossi became interested in vision science as an undergraduate student at the University of Rochester, which continued as he pursued his graduate degree at University of California, Berkeley in the Vision Science program, where he joined Austin Roorda’s Adaptive Optics lab. He explains “I was working to understand what the limits are to vision and how well we can see if we remove the eyes optics as the limitation. AO can correct the eye’s aberrations to image the cells in the retina. But it is also useful for delivering images into the eye that are of higher optical quality than the retina has ever experienced. This allowed us to probe 4

In using the Adaptive Optics technology, Dr. Rossi aims to revolutionize how we understand disease patterns and provide physicians the opportunity to intervene at an earlier state of disease, like agerelated macular degeneration (AMD) and glaucoma, to prevent vision loss. the limitations of the retina and the brain and understand their capabilities when optics no longer limited performance.”

After completing his doctoral degree, Dr. Rossi returned to the University of Rochester to complete his postdoctoral training, and it was there that he began using AO to study AMD at a cellular level. His postdoctoral work adapted advanced techniques and developed new ones for imaging new cell classes in patients, including retinal pigment epithelium (RPE) cells. There, he began working with Canon, the Japanese imaging technology giant, to develop the first commercial prototype AO systems, that would incorporate these new imagining capabilities and to improve the technology for clinical imaging.

It was through a colleague at Berkeley that Dr. Rossi first connected with Dr. Sahel, who, at the time was still at the Institut de la Vision in Paris. “Dr. Sahel saw, from the beginning, how important high-resolution imaging

would be to understanding retinal diseases and his life’s work in vision restoration.”

While Dr. Rossi was considering offers from other Universities last year, he heard about the possibility of Dr. Sahel’s relocation and knew he needed to look into Pittsburgh.

He was looking to find the right kind of academic environment and wanted to be a part of something new and exciting. “I visited Pittsburgh last year for the first time with Leah Byrne, another recruit. We both were very impressed by the Department and Pitt’s Medical School, in addition to the support from Dean Levine. All of the faculty we met gave us a positive feeling about what it would be like to work here and the extremely collaborative environment. In learning more about Pittsburgh, I discovered the hightech presence here and how Pittsburgh had revolutionized itself as a hub for technology and medicine. I knew this was where I needed to be.”

through the use of high throughput DNA sequencing methods, she is able to track and control this process with unprecedented accuracy. An important aspect of this work is that Dr. Byrne is focusing on new therapies and delivery mechanisms that work in large animals. Dr. Byrne is using these vectors to develop and test treatments for retinitis pigmentosa, Leber’s congenital amaurosis, and other diseases in these large animal models. This work is essential for bridging

Leah Byrne, PhD, Assistant Professor of Ophthalmology

by Carrie Fogel

Leah Byrne, PhD joins the Department of Ophthalmology faculty this spring from California, where she finished a postdoctoral fellowship at University of California, Berkeley. Dr. Byrne’s research works toward finding genetic therapies for inherited retinal diseases, such as retinitis pigmentosa. The nature of her research centers on the use of Adeno Associated Viral (AAV) vectors to target dysfunctional genes and to deliver nucleic acid polymers into a patient’s cells to treat the disease. “Using viral vectors, we can deliver a copy of a gene to replace one that isn’t working properly, or deliver a therapeutic gene that will bring new functionality to the retina. Also, the development of tools for directly editing the genome, such as CRISPR/ Cas9, has opened up brand new avenues for treatment of many forms of inherited retinal disease. The rapid pace of discovery and the potential we see makes this an exciting time to be working in the field of gene therapy,” says Dr. Byrne. She notes that there are major hurdles to overcome and a lot of work to be done before the discoveries can be translated into effective treatments. “I’m thrilled to be starting a research group at the University of Pittsburgh, and to have the opportunity to work towards advances that will make a significant impact on the lives of patients.”

Dr. Byrne began her education in the neuroscience field, completing her undergraduate studies at Hamilton College in New York and then going on to pursue her PhD in Neuroscience at UC Berkeley.

She was first drawn to work in the retina due to the importance of vision in daily life and the potential for translational research to treat retinal disease, as well as the wellcharacterized structure and function of the retina, and its approachability and close relationship to the brain. “My background is in neuroscience, and my work in gene therapy focuses on the retina because it’s

a well-understood and approachable part of the brain, and an incredibly important part of the brain as well. At the same time, progress made in treating and understanding the retina can be applied to other parts of the brain and other tissues. There is a potential for our research to make a huge impact on the lives of patients, and that is the ultimate goal of our work.”

Dr. Byrne completed her doctoral degree working in John Flannery’s laboratory at Berkeley, developing AAV gene therapies for retinal disease. While working on her PhD, Dr. Byrne was granted the Scientific Bourse Chateaubriand Fellowship, awarded by the French Embassy in an effort to foster collaboration between American and French researchers. Leah spent one year working at the Institut de la Vision (IDV) in Paris, where she collaborated with vision scientists and met Dr. José-Alain Sahel. During her time at IDV, Dr. Byrne made lasting connections with the French team and has sustained long-term scientific collaborations that have resulted in a number of significant publications. Following this, Dr. Byrne returned to the U.S. to complete her postdoctoral training, receiving a Ford Foundation Fellowship, awarded by the National Academies, and a Ruth L. Kirschstein NRSA Postdoctoral Fellowship from the National Eye Institute to work at UC Berkeley and UPenn. Her ongoing research aims to create gene therapies and testing them in large animal models, whose eyes are structurally similar to the human eye, but present more complex physical barriers to AAV vectors. To accomplish this, Dr. Byrne is using a process called directed evolution to create new viral vectors with advanced capabilities to deliver genetic material to the eye and novel therapies for inherited retinal disease. Directed evolution harnesses the process of evolution that occurs in nature, reproducing it in a controlled laboratory setting and at an accelerated timescale. And

the gap between the bench and the clinic, and finding cures for previously untreatable conditions that will work efficiently and permanently for patients with a wide variety of conditions. Looking forward, Dr. Byrne is focusing her attention on the most important issues surrounding gene therapy, including expanding the types of available treatments for mutations with dominant inheritance patterns and genes that are too large to be delivered using existing technologies.

Dr. Sahel contacted Leah once he made his decision to come to the U.S.; he knew that, because of the resources available here, including the formal arrangement with the Vision Institute, the University of Pittsburgh would be an ideal place for Leah to pursue her research. “I came to Pittsburgh and was impressed with all of the resources that Pitt could make available, and the atmosphere of energy and possibility, and I was also excited to work with Dr. Sahel again. Most importantly, I knew here I could realize all my scientific goals. ” In addition to the physical resources, Dr. Byrne found herself drawn to the supportive and engaged network of scientists and was excited at the possibility of directly interacting with and working alongside physicians.

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Fighting Aging and Dementia with Hearing

by Carrie Fogel

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here is growing evidence that impaired hearing is related to poor health outcomes in aging individuals. One of the most serious consequences of hearing loss is the associated decline in an individual’s cognitive function. The older an individual lives, the more likely they are to experience hearing loss. In the Department of Otolaryngology, Dr. Catherine Palmer, Director of Audiology, and her team are looking for ways to implement audiology into the standard care that older adults receive in order to prevent the onset of many negative side-effects of hearing loss, including cognitive decline and depression.

Dr. Palmer is passionate about finding innovative ways to solve these problems associated with hearing loss. In December, the Eye & Ear Foundation received a grant from

the Fine Foundation to address the burdens of hearing loss on older adults.

Sheila Fine, along with her husband Milton, feel strongly about this topic, because of the implications hearing Catherine Palmer, AUD, PhD loss can have on

healthy aging. Mrs. Fine, co-founder of the Fine Foundation, recently said, “Learning that hearing loss negatively affects our brains was striking information. This is especially concerning as we will all age and may face cognitive challenges, such as dementia. I am pleased to learn there is a way we can preserve what function we have in our brain through hearing assistance.”

With the generous support from the Fine Foundation, Dr. Palmer and her team will begin a project to embed an audiology clinic within the existing Geriatric Care Center in an effort to provide accessible, affordable hearing healthcare within a clinic that already serves the target population. To our knowledge, this type of inter-professional clinic does not exist elsewhere. Under Dr. Palmer’s direction, the team also seeks to provide individuals with a cost-effective mechanism to access hearing health care in the location of their geriatric primary care. This model allows for greater access to care, and for financing hearing assistive devices in a manner that allows the patient (and their family) to make the best decisions for their situation. The amount of relief that this service can provide to individuals and families as they navigate healthy aging is sure to be substantial.

Preserving Children’s Vision in our Community

by Carrie Fogel

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t Children’s Hospital of Pittsburgh, our vision for Pediatric Ophthalmology is to develop a multidisciplinary clinical and research program that leads to clinical improvement and perpetual research motion resulting in a measurable outcomes, and in so doing, becomes the standard of care for children with eye diseases.

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The Vision Enhancement Center (VEC) was founded four years ago to serve as a central hub of expertise and connectivity for children suffering from eye diseases within Allegheny County. The VEC is a community partnership of service organizations, schools, clinical practices, and educational services with a common goal to support and serve blind and low-vision children and their families. The driving goal behind the VEC is accessibility.

The VEC strives to be a point of entry to understanding the world with a newlydiagnosed child with visual impairment. To

that end, the VEC will soon debut its new, comprehensive website, where children, parents, teachers and care providers can access useful information regarding services and opportunities in our area.

In 2014, the Jack Buncher Foundation helped support the first phase of building necessary infrastructure for the Vision Enhancement Center. As a result, we had success in connecting more individuals and organizations in the community to the VEC and engaging partner organizations at a higher level to combine our goals and work towards achieving them as a team. In order to complete Phase One of this project, the Jack Buncher Foundation generously committed to support our efforts to discover more about the genetics of blindness.

By seeking to understand and studying rare eye diseases, the pediatric ophthalmology scientists, led by Dr. Ken Nischal, Chief,

Division of Pediatric O p h t h a l m o l o g y, have made discoveries as to how and why ocular conditions occur and what genetic changes are responsible for the development of these diseases. Ken Nischal, MD, FRCOphth The generous support from the Jack Buncher Foundation allows us to provide each child with a chance to enhance his or her global development, so that they may lead a happier, more productive, and independent life. This incredible gift to support the Vision Enhancement Center’s work allows us to leverage more resources within our network of partners to solve the big problem of childhood blindness.

CREATing New Pathways to Improve Surgery

by Heather Chronis

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urgeons from around the world will have more options to learn minimally invasive surgical techniques on the first floor of the Eye and Ear Institute within the next year. Under the leadership of Jonas Johnson, MD, Chairman, the Department of Otolaryngology at the University of Pittsburgh is breaking ground on a stateof-the-art surgical education and surgical innovation center aptly named, Pittsburgh Collaboration for Research, Education, and Technology Enhancement for Surgery (CREATES) that will allow for year round training of surgeons, along with enhanced telementoring opportunities. In addition, there will be space designed specifically for surgeons to work with industry on developing and improving products that will help propel the next stage of minimally invasive surgery. An early supporter of CREATES is Eugene N. Myers, MD, Chairman Emeritus of the Department of Otolaryngology, who began the department’s international outreach and educational efforts in the 1970’s, at the beginning of his leadership tenure. In December 2016, Dr. Myers, through the Myers Family Foundation, provided a generous donation in support of the Pittsburgh CREATES initiative.

For over 30 years, the Center for Skull Base Surgery has been a pioneer in developing minimally invasive techniques to access sinus and brain tumors through the nose.

The Center conducts training sessions several times a year for teams of surgeons to learn these techniques. Under the

A CREATES robotic surgical training laboratory.

Dr. Carl Snyderman, Dr. Eugene Myers, and Dr. Uma Duvvuri with the training robot in one of the CREATES Innovation rooms. direction of Carl Snyderman, MD, Professor of Otolaryngology and Neurological Surgery, and Paul Gardner, MD, Associate Professor of Neurological Surgery, these four-day training courses are extremely popular and have a multiyear waiting list. Currently, the hands-on training takes place in a shared space at the School of Medicine’s Scaife Hall with limitations on availability and function. With CREATES, surgeons will have the opportunity to learn new techniques in a state-of-the-art space, which will include 20 training stations outfitted with modern equipment and teleproctoring capabilities.

A comprehensive surgical simulation laboratory, including the addition of plastinated specimens and surgical skill simulations, will allow for greater opportunities for perfecting surgical techniques. Surgeons will also have the opportunity to visit CREATES for individualized training.

To perform minimally invasive surgery with the greatest expertise, surgeons also need state-of-the-art equipment.

With the surgical innovation component of CREATES, companies that manufacture surgical equipment will have the ability to have their products tested and receive feedback from surgeons of various specialties. Uma Duvvuri, MD, PhD, Assistant Professor of Otolaryngology, has been actively working with Medrobotics for

several years on product innovation and is the first surgeon to use their Flex Robotic System in the operating room. Additionally, CREATES has the first flex robot that the company produced for training.

Dr. Duvvuri is currently collaborating with other companies to bring their latest innovations to CREATES. In addition to Otolaryngology and Neurosurgery, many other departments at the University of Pittsburgh will eventually utilize CREATES, including Ophthalmology and General Surgery. Dr. Duvvuri is currently working with Inderpal Sarkaria, MD, of the Department of Cardiothoracic Surgery to test new technologies for removing esophageal tumors, which could provide a less invasive treatment option for patients.

Sharing surgical techniques and developing surgical technologies for the future helps to ensure that the next generation of surgeons will be fully trained to treat the most complex problems in the least invasive way possible.

The core of CREATES is collaboration and this is the gift that the Department of Otolaryngology at the University of Pittsburgh is sharing with the world.

Please contact Heather Chronis at the Eye & Ear Foundation at heather@eyeandear.org or 412 383 8749 to tour the CREATES space or for individual giving opportunities.

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New Technology to Improve Outcomes for Glaucoma Surgery

by Heather Chronis

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new surgical procedure for relieving the ocular pressure from glaucoma is now being performed at the UPMC Eye Center. Ian Conner, MD, PhD, Assistant Professor of Ophthalmology, Glaucoma and Cataract Service at the University of Pittsburgh School of Medicine is the first surgeon in Pittsburgh, and one of only a dozen nationally, who are implanting a gel based stent in the eye, using the product, XEN (pronounced Zen), Developed by Allergan, the treatment has been available internationally for nearly a decade and is now available in the United States following FDA approval in late 2016.

The procedure is performed under topical anesthesia and it takes less than thirty minutes to implant the stent. The stent assists in the management of refractory glaucoma and is indicated for both patients who have not achieved optimal results with previous surgery or have never had glaucoma surgery. The gel stent allows for another option to reduce intraocular pressure (IOP), one of the hallmarks of glaucoma. While patients that have not had success with other procedures are good candidates for the XEN stent, perhaps the best candidates are those patients who have not previously had surgery.

“A pristine ocular surface without scar tissue produces the best surgical outcomes,” said Dr. Conner, but also states that the procedure is not limited to just those patients.

Patients have a quicker recovery time with the gel stent than with traditional glaucoma surgery. “Patients are usually good the same day and have very little down time.

The eye is usually very tender and sore after traditional glaucoma surgery; however, with the XEN stent, the eyes are not sore and the patient can quickly resume normal activity,” says Dr. Conner. This product is a potentially revolutionary option for patients with high intraocular pressure, similar to when cataract surgery shifted from a multiple day stay in the hospital to an outpatient procedure.

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The Eye & Ear Foundation of Pittsburgh is a non- profit 501 (C)(3) organization. Our mission is to support the research and the academic efforts of the Departments of Ophthalmology and Otolaryngology at the University of Pittsburgh School of Medicine.

Donations to the Eye & Ear Foundation help to advance groundbreaking research in the Departments of Ophthalmology and Otolaryngology, as well as to help forge exciting new collaborations among various departments, scientists, and physicians.

With your help, we are building an innovative model of medicine!

To donate to the Eye & Ear Foundation, please return the enclosed envelope or visit eyeandear.org. You also have the option of calling our office directly for information on our research projects or for assistance in making a gift, 412-864-1300.

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Dr. Ian Conner performing the XEN gel based stent procedure.

This new treatment is a complement to the Department of Ophthalmology’s Initiative to Cure Glaucoma headed by Nils Loewen, MD, PhD. While Dr. Loewen and his fellow researchers continue to make great strides in investigating new ways to restore the outflow tract, which holds the key to intraocular pressure, the gel stent technique provides surgical relief for patients today. Plans are being made for Dr. Loewen to also perform the XEN procedure, which will provide patients of the Department of Ophthalmology another resource for this innovative surgical procedure.

The introduction of XEN gel stent by Dr. Conner is yet another groundbreaking surgical technique for the Department of Ophthalmology at the University of Pittsburgh. Reduced downtime for the patients combined with less tenderness in the eye post-surgery from this procedure provide patients with a revolutionary new way to combat glaucoma.

If you would like to make an appointment with Dr. Conner, please contact the UPMC Eye Center at 412-647-2200.

The clinic includes routine checkup and surveillance for tumors. It also includes the opportunity to have a specialized evaluation of swallowing, if swallowing difficulties have developed. The next step is to be evaluated by Dr. Antonia Teruel, a dentist, who has special interest and expertise not only in caring for existing teeth, but looking into different causes of and treatments for oral pain.

Dr. Antonia Teruel, a dentist, who has special interest and expertise not only in caring for existing teeth, but looking into different causes of and treatments for oral pain.

Currently, we are offering a screening for hearing loss, as patients develop some hearing loss after surgery or radiation. A physical therapist will be available to help people who need assistance in maintaining motion and strength in their jaw, neck, and shoulders. We are also linked to professionals in behavioral health to facilitate referrals for mental health assessment and treatment.

Our efforts in the Survivorship Clinic are to identify patients who need help and then to provide access to resources, which may improve quality of life. All patients who have been treated for cancer of the head and neck are invited to be evaluated. Access to these facilities is counted as a single doctor’s visit and patients will not be required to deal with multiple payments or copayments.

To make an appointment with the Survivorship Clinic, call 412-647-2100.

eyeandear.org 203 Lothrop Street Suite 251 EEI Pittsburgh, PA 15213 412.864.1300 O 412.864.1305 F

UPMC Eye Center

(412) 647-2200

University Ear, Nose & Throat Specialists of UPMC

(412) 647-2100

If you no longer wish to receive our newsletter, please submit requests to our mailing address, or email optout@eyeandear.org The official registration and financial information of the Eye & Ear Foundation may be obtained from the Pennsylvania Department of State by calling toll free, within Pennsylvania, 1-800-732-0999.

Registration does not imply endorsement.

The Eye & Ear Foundation of Pittsburgh is a nonprofit 501 (C)(3) organization. Our mission is to support the research and academic efforts of the Departments of Ophthalmology and Otolaryngology at the University of Pittsburgh. Donations to support our research initiatives can be made online at eyeandear.org or by returning the enclosed envelope. For more information on the Foundation, our research, or the articles in this newsletter, please contact Katherine Troy, Director of Operations, at katherine@eyeandear.org or 412-864-1300.