On this week's episode of The Oculofacial Podcast, host Phil Tenzel and guests Zac Keenum and David Della Rocca discuss utility of phenylephrine testing in mullerectomy planning, an ultra-low-dose radiotherapy regimen for treatment of ocular adnexal lymphoma, and comparing two different surgical approaches of treating periocular melanoma in situ.

Resources:
American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS): asoprs.org

Participant names:

Dr. Evan Kalin-Hajdu (host), Dr. Jeffrey A. Nerad (panelist), Dr. David Jordan (panelist), Dr. Robert C. Kersten (panelist)

Episode Summary

Dr. Evan Kalin-Hajdu hosts this episode of The Oculofacial Podcast. Dr. Kalin-Hajdu is an assistant professor of Ophthalmology at the University of Montreal in the division of Oculofacial Plastic Surgery. The panel includes Dr. Jeffrey A. Nerad, Dr. David Jordan, and Dr. Robert C. Kersten. Dr. Nerad is an Oculofacial Plastic Surgeon in private practice in Cincinnati, Dr. Jordan is a Professor of Ophthalmology at the University of Ottawa in the division of Oculofacial Plastic Surgery, and Dr. Kersten is a Professor of Ophthalmology at the Moran Eye Center at the University of Utah in the division of Oculofacial Plastic Surgery.

Drs. Nerad, Jordan and Kersten are icons of the field of Oculofacial Plastic Surgery. Combined, they have nearly 700 peer reviewed publications and an innumerable list of awards, guest speakerships, textbooks, and book chapters. Dr. Kalin-Hajdu engages these three legendary panelists to discuss their most memorable cases. The incredible cases touch subjects ranging from psychiatry to oncology to nutrient deficiencies.

• American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS): asoprs.org

• Journals and Publications for related case studies, such as Survey of Ophthalmology

We invite you to delve into the full episode for these extraordinary and educational case discussions. Stay tuned to the Oculofacial Podcast for more inspiring content and insights from the world of oculoplastic and reconstructive surgery.

Dr. Davin Ashraf is an Assistant Professor of Ophthalmology at the Casey Eye Institute (Oregon Health and Science University) in the division of Oculofacial Plastic Surgery. He acts as host in this episode of the Oculofacial Podcast.

Dr. Robert Kersten is a Professor and ASOPRS Fellowship Program Director at the Moran Eye Center (University of Utah) within the division of Oculoplastic and Facial Plastic Surgery.

Dr. Shravani Mikkilineni is an oculofacial surgeon in private practice at Consultants in Ophthalmic and Facial Plastic Surgery in the metro Detroit area.

Dr. Emily Li is an Assistant Professor at the Wilmer Eye Institute (Johns Hopkins University).

Episode Summary:

Dive into the November-December 2024 issue of Oculofacial Plastic and Reconstructive Surgery (OPRS) as Dr. Davin Ashraf leads engaging discussions with expert colleagues Dr. Robert Kersten, Dr. Shravani Mikkilineni, and Dr. Emily Li. The episode covers cutting-edge topics and insightful research findings in oculoplastic surgery, providing listeners with an in-depth understanding of the latest surgical techniques and postoperative outcomes in the specialty.

Dr. Robert Kersten initiates the podcast with an exploration of the phenylephrine test's influence on the outcomes of external levator advancement surgery. Key discussions revolve around the phenylephrine's role in selecting the appropriate approach to ptosis surgery and its implication for eyelid compliance. Following this, Dr. Shravani Mikkilineni highlights significant corneal astigmatism changes post-levator surgery, sparking considerations for toric intraocular lens surgery timing. Dr. Emily Li concludes the episode by presenting an innovative surgical technique to address punctal stenosis, prompting dialogue on traditional methods' efficacy. Together, these discussions offer a comprehensive look into evolving methodologies and patient management strategies in oculoplastic surgery.

Key Takeaways:

• Phenylephrine Test Utilization: Dr. Kersten discusses how phenylephrine positive patients had better outcomes in external levator resection and challenges common practices involving phenylephrine tests.

• Corneal Astigmatism Considerations: Changes in corneal astigmatism post-levator surgery could impact future toric IOL procedures, emphasizing the need for careful preoperative evaluation.

• Novel Approach to Punctoplasty: The podcast explores traditional versus novel techniques in handling punctal stenosis, weighing practicality against surgical outcomes.

Resources:

• Casey Eye Institute, Oregon Health and Science University

• Moran Eye Center, University of Utah

• Wilmer Eye Institute, Johns Hopkins University

• Consultants in Ophthalmic and Facial Plastic Surgery

Explore this enlightening episode to gain valuable insights and stay informed about critical topics in the field of oculoplastic surgery. Be sure to tune in for future episodes filled with expert discussions and cutting-edge discoveries in ophthalmology.

About the Guests

Dr. John Holds is a leading oculoplastic surgeon at Ophthalmic Plastic and Cosmetic Surgery, Inc., located in St. Louis, Missouri. With decades of experience, Dr. Holds has performed over 800 lower blepharoplasty surgeries, focusing on fat transposition techniques. He is a published author, contributing significant knowledge to the field of oculofacial surgery.

Dr. Marie Somogyi is an esteemed eyelid and facial plastic surgeon with Eyelid and Facial Plastic Surgery Associates in Austin, Texas. Known for her expertise in lower blepharoplasty procedures, Dr. Somogyi utilizes the subperiosteal plane in fat transposition and is recognized for her innovative approach to incorporating autologous fat transfer.

Episode Summary:

Join Dr. Natalie Homer and special guests, Dr. John Holds and Dr. Marie Somogyi, in this engaging episode of the Oculofacial Podcast, where they dive into the intricacies of surgical techniques in lower blepharoplasty, exploring the preperiosteal versus subperiosteal fat transposition methods. As the debate unfolds, you’ll discover how each specialist approaches their craft, armed with unique techniques honed through years of experience. With a pre-debate poll showing a strong preference for the subperiosteal method, Dr. Holds presents a robust defense of the preperiosteal approach, while Dr. Somogyi passionately advocates for the subperiosteal technique.

The experts delve into various aspects of lower blepharoplasty, including management strategies for the three fat pads, differences in postoperative recovery, and personalized approaches for patient-specific outcomes. Through their insightful discussions, Dr. Holds emphasizes the vascular benefits of the preperiosteal plane, while Dr. Somogyi highlights the structural advantages of subperiosteal placement. This episode provides a comprehensive overview of aesthetic and functional considerations for both techniques, offering valuable insights for practitioners and patients alike.

Key Takeaways:

• Fat Transposition Techniques: Dr. Holds and Dr. Somogyi debate on the efficacy and benefits of preperiosteal versus subperiosteal planes, each presenting evidence and personal experiences.

• Surgical and Postoperative Differences: The podcast details key differences in surgical processes and post-operative outcomes of the techniques, including potential impacts on hemostasis and edema.

• Patient-Specific Approaches: The experts discuss tailoring techniques based on individual patient characteristics, including considerations for patients with festoons or previous filler use.

• Orbicularis Muscle Management: Both specialists share their methods for handling the orbicularis muscle in lower blepharoplasty to prevent complications like lower eyelid retraction.

• Canthoplasty Techniques: Insights are provided on strategies to support the lateral canthus, offering suggestions like temporary tarsorrhaphy to enhance patient outcomes.

Resources:

• Dr. John Holds at Ophthalmic Plastic and Cosmetic Surgery, Inc. (Website not explicitly mentioned but relevant)

• JAMA Facial Plastic Surgery (For referenced 2013 study by Dr. Masary)

To delve deeper into the nuances of oculofacial surgery, listen to the full episode and stay tuned for more enlightening discussions on the Oculofacial Podcast.

If you're an ASOPRS Member, Surgeon or Trainee and are interesting in hosting a podcast episode, please submit your idea by visiting: asoprs.memberclicks.net/podcast

About the Guest(s):

Dr. Ken Morgenstern is a renowned Oculofacial Plastic and Reconstructive Surgeon in private practice in Philadelphia, Pennsylvania. He is also an Associate Professor at Wills Eye Hospital and Thomas Jefferson University. In 2024, Dr. Morgenstern served as the President of the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS). His distinguished career includes significant contributions to the field of oculofacial plastic surgery, as well as active involvement in the governance and policy-making aspects of ASOPRS.

Dr. Grant Moore is an oculofacial plastic surgeon in Phoenix and Scottsdale, Arizona. He is an Assistant Clinical Professor of Ophthalmology and Oral-Maxillofacial Surgery at the University of Arizona College of Medicine. He is the chair of the ASOPRS Podcast Workgroup.

Episode Summary:

In this milestone 50th episode of The Oculofacial Podcast, host Dr. Grant Moore, an oculofacial plastic surgeon in Phoenix and Scottsdale, Arizona interviews Dr. Ken Morgenstern, the outgoing President of ASOPRS. The episode features a discussion with Dr. Morgenstern about his tenure as ASOPRS president in 2024. Dr. Morgenstern delves into the achievements and challenges of his presidential term, including advocacy for a more comprehensive board certification process and the creation of an effective and equitable conflict of interest policy for ASOPRS board members. He also covers the significance of diversity and open dialogue in shaping organizational policies and propelling progressive transition within the society.

Key Takeaways:

· Leadership and Vision: Dr. Morgenstern spotlights major developments during his tenure, including enhanced board certification efforts and development of a conflict of interest policy.

· Advocacy and Representation: Insights into the need for greater advocacy for oculofacial surgeons to ensure fair practices and adequate representation in broader medical contexts.

· Strategic Transformation: Emphasizing the importance of adaptability and embracing change to maintain relevance and efficacy within professional societies.

· Community and Education: Dr. Morgenstern stresses continued education for members on complex issues and fostering volunteerism for the society's growth.

Notable Quotes:

1. "Board certification is essential for our advocacy, giving us a voice and recognition in the medical community."

2. "Embracing diverse perspectives really strengthens the decision-making process and our society's evolution."

3. "Persistence in getting involved and learning through various committees has been key to my professional growth."

Explore more on the transformation and upcoming initiatives in the oculofacial community by listening to the full episode. Stay connected for more enlightening discussions and insights by subscribing to the "Oculofacial Podcast."

If you're an ASOPRS Member, Surgeon or Trainee and are interesting in hosting a podcast episode, please submit your idea by visiting: asoprs.memberclicks.net/podcast

Dr. Roger A. Dailey, MD, FACS: He is a renowned ophthalmologist and faculty member at Oregon Health & Science University, specializing in oculoplastics. Dr. Dailey has a vast professional history, starting his residency in 1983, and has made significant contributions to the development of oculoplastic procedures and education.

Dr. Jack Wobig, MD, MBA, FACS: A retired ophthalmologist with a rich legacy in oculoplastic and orbital surgery. Dr. Wobig was a key figure at OHSU and spent decades in private practice and teaching, contributing significantly to the field through his research and collaborations, most notably with Lester Jones.

Dr. Andrew Harrison, MD: An oculoplastic and orbital surgeon at the University of Minnesota, Dr. Harrison is well-versed in advanced surgical techniques. He completed his fellowship with Dr. Wobig and Dr. Dailey and continues to advance the field through both his surgical practice and academic contributions.

In this engaging episode of the ASOPRS podcast, hosts Dr. Roger Dailey and Dr. Andrew Harrison are joined by the legendary Dr. Jack Wobig to delve into the rich history and evolution of oculoplastic surgery. The conversation hones in on Dr. Wobig's remarkable career, including his professional journey, collaborations with Lester Jones, and the innovative development of the Jones tube for lacrimal duct surgeries. This episode not only offers a window into the pioneers of oculoplastics but also provides valuable insights for future surgeons.

Throughout the discussion, the guests highlight various milestones in the field of oculoplastics, emphasizing the importance of anatomical precision and collaboration in surgical innovations. The trio reminisces about shared experiences, with anecdotes that underscore the transformative impact of their mentors and colleagues. By examining the past and contemplating future challenges and opportunities, the episode paints a comprehensive picture of the field's trajectory. Insights into educational practices, the expanding global impact of Aesoppers, and the evolving dynamics of surgical training provide both a nostalgic and forward-looking view on the practice of oculoplastics.

• Historical Insights: Exploration of Dr. Jack Wobig’s collaboration with Lester Jones in developing the Jones tube and its impact on lacrimal surgery.

• Evolution of ASOPRS: Discussion on the early days of ASOPRS, its formation, and Dr. Wobig's presidency, highlighting the challenges and growth in training and standards enforcement.

• Educational Influence: Reflections on the importance of international exposure and collaboration in shaping successful careers in oculoplastics.

• Retirement Advice: Dr. Wobig shares perspectives on retirement, the value of lifelong learning, and the fulfillment derived from a meaningful career and rich family life.

• Lifelong Relationships: Emphasis on the importance of maintaining connections with colleagues and fellows, fostering a family-like environment within the surgical community.

Dr. Bradford Lee

• Associate Clinical Professor at the University of Hawaii School of Medicine and private practitioner in Honolulu.

• Chair of the DEI (Diversity, Equity, and Inclusion) Committee for ASOPRS.

Dr. Andrea Kossler

• Associate Professor of Ophthalmology, Stanford University School of Medicine

• Director of Oculofacial Plastic Surgery and Orbital Oncology at Stanford University.

• Board member of the Women in Ophthalmology and LATINOUS.

Dr. Cesar A. Briceño

• Chief of Oculoplastics at Shea Eye Institute, University of Pennsylvania.

• Assistant Dean for Diversity and Cultural Affairs at the Perelman School of Medicine, UPenn.

Dr. Eydie G. Miller-Ellis

• Chief of the Glaucoma Service at the University of Pennsylvania.

• Co-director of the RAB Venable Excellence in Research Project for the NMA.

Dr. John Ng

• Division Chief and Professor of Oculofacial Plastic, Orbital, and Reconstructive Surgery at Casey Eye Institute, Oregon Health & Science University.

• Incoming Vice President of Aesoppers and future President.

Dive into an engaging panel discussion on Diversity, Equity, and Inclusion (DEI) within the sphere of ophthalmology, specifically exploring its role in oculoplastic surgery. Hosted by Dr. Bradford Lee and Dr. Andrea Kossler, this episode of Top offers profound insights into the initiatives promoting more inclusive and equitable practices in ophthalmology associations and medical education institutions. With esteemed panelists like Dr. Cesar Briceño, Dr. Eydie G. Miller-Ellis, and Dr. John Ng, the conversation shifts focus on innovative programs like the DEI Committee for ASOPRS, which prioritizes inclusion, access, and diversity for both practitioners and patients.

The episode explores the intersection of DEI and patient care, highlighting how diverse medical professionals contribute to an enriched healthcare delivery model, thereby mitigating disparities in vision health care. The insightful contributions also touch upon the importance of justice within DEI efforts, as well as the significance of recognizing intersectionality among trainees and patients, which brings emphasis to the unseen and complicated layers impacting healthcare accessibility and delivery.

• The DEI Committee for ASOPRS is actively fostering inclusion and access through travel and research grants, as well as mentorship programs to promote diverse career pathways in ophthalmology.

• Diversity improves patient care outcomes by fostering a workforce that understands and respects varied cultural and socioeconomic backgrounds.

• Institutions must strive to create equitable support systems for trainees from diverse backgrounds to ensure they can excel in specialized fields like oculoplastic surgery.

• Addressing intersectionality is crucial in understanding the multifaceted barriers faced by diverse groups, ensuring a more comprehensive approach in medical research and education.

• Programs like the RAB Venable Excellence in Research Project aim to increase genetic representation in clinical trials, crucial for advancing targeted treatments.

Listeners are encouraged to delve deeper into this vital discussion on DEI within ophthalmology by tuning in to the full episode. Stay connected for more insightful and enlightening conversations from our series.