Dale Heuer's guest appearances

Dale Heuer

Talking About Glaucoma (AAC)

Talking About Glaucoma (mp3)

Steve Sarkisian

Robert Schertzer

Josh Ehrlich

Nelson Winkler

Marcelo Nicolela

Karim Damji

Gus DeMoraes

Suman Thapa

Richard Hom

GEDDE Steve

SIEGFRIED Carla

OwlTail

In this episode, Dr Dale Heuer and I discuss the latest glaucoma surgical techniques and devices in search of solid evidence for their safety and effecacy. Trabeculectomy is the operation that we love to hate so we are always looking for something better. In some countries, new devices just require proving safety without having to show efficacy whereas in other countries both must be proven. Canaloplasty involves threaded a fibre-optic canula around the full circumference of Schlemm’s canal, using viscoelastic to then dilate the canal, pull a suture through to tighten it and change the canal’s position, then creating a descemet’s window before closing. The ExPress mini-shunt is a metal tube under a trabeculectomy scleral flap to create a more predictable trab. The trabectome removes the trabecular meshwork with cautery. The iStent implant is a metal snorkle creating a direct communication between the anterior chamber and Schlemm’s canal. An ER:YAG laser technique of creating direct communication between the AC and the canal has been pioneered by Dr MIchael Berlin but has still not gained traction. Other blebless techniques including the SOLEX gold plate used to create a cyclodialysis are still being tried. In the end, we still have our proven trabeculectomy as well as tube-shunt glaucoma drainage devices, both of which we have solid evidence of safetly and efficacy.As an addendum, during the show I mentioned that I was going to be performing canaloplasty in the future. I have now performed three surgeries and have three more booked for March 2011. The procedure is like angioplasty for the eye compared with a trabeculectomy or other bleb forming surgeries that are more like bypass surgeries. There is also 4 year data showing canaloplasty success with IOP lowering &gt;30% so this does show some promise as one of the new surgeries though it is technically a bit more complicated despite being less invasive than a trab.————————————Dale K. Heuer, MDProfessor &amp; Chairman, Department of OphthalmologyMedical College of WisconsinDirector, Eye InstitutePhone: (414) 955-2020FAX: (414) 955-6300E-mail: dheuer@mcw.eduThe Eye Institute925 N. 87th St.Milwaukee, WI. 53226 http://www.mcw.edu/ophthalmology/faculty/FacultyProfiles1/DaleKHeuerMD.htm————————————This episode was recorded at the West Coast Glaucoma Centre in Vancouver, BC, on November 19, 2010.  The recording gear for this episode included the Blue Microphones YETI, MacPro, Iomega SSD Flash external drive and Audio Hijack Pro software. Fission was used to convert the audio file to AIFF for Levelator to balance the sound levels. The final audio editing, chapter markers, show notes and images were put together using Garage Band ‘11 on an 11” MacBook Air. I have a lot of fun doing this by myself and recording these interviews with my colleagues. Look for more episodes as I still have another couple that are recorded that I have to edit.Opinions expressed in this podcast are those of the speakers and are not intended to be taken as the standard of care for glaucoma treatment. Please always weigh the complete clinical picture and involve patients with any decisions in their care. Robert M Schertzer, MD, MEd, FRCSCClinical Associate ProfessorDept of Ophthalmology &amp; Visual SciencesUniversity of British Columbiapodcast@iguy.orghttp://iguy.tv/podcasthttp://iguy.tv is now set-up as a page to connect you to all my bits and bytes all over the web; go to that landing page as a convenient one-stop hub to all my activitiesWork -    http://westcoastglaucoma.comor http://iguy.tv/officeTwitter - http://twitter.com/robschertzeror http://iguy.tv/twitterBlog -     http://wholelottarob.comor http://iguy.tv/blog © Robert M Schertzer MD Inc, 2011

In this episode, Dr Dale Heuer and I discuss the latest glaucoma surgical techniques and devices in search of solid evidence for their safety and effecacy. Trabeculectomy is the operation that we love to hate so we are always looking for something better. In some countries, new devices just require proving safety without having to show efficacy whereas in other countries both must be proven. Canaloplasty involves threaded a fibre-optic canula around the full circumference of Schlemm’s canal, using viscoelastic to then dilate the canal, pull a suture through to tighten it and change the canal’s position, then creating a descemet’s window before closing. The ExPress mini-shunt is a metal tube under a trabeculectomy scleral flap to create a more predictable trab. The trabectome removes the trabecular meshwork with cautery. The iStent implant is a metal snorkle creating a direct communication between the anterior chamber and Schlemm’s canal. An ER:YAG laser technique of creating direct communication between the AC and the canal has been pioneered by Dr MIchael Berlin but has still not gained traction. Other blebless techniques including the SOLEX gold plate used to create a cyclodialysis are still being tried. In the end, we still have our proven trabeculectomy as well as tube-shunt glaucoma drainage devices, both of which we have solid evidence of safetly and efficacy. As an addendum, during the show I mentioned that I was going to be performing canaloplasty in the future. I have now performed three surgeries and have three more booked for March 2011. The procedure is like angioplasty for the eye compared with a trabeculectomy or other bleb forming surgeries that are more like bypass surgeries. There is also 4 year data showing canaloplasty success with IOP lowering &gt;30% so this does show some promise as one of the new surgeries though it is technically a bit more complicated despite being less invasive than a trab. ———————————— Dale K. Heuer, MD Professor &amp; Chairman, Department of Ophthalmology Medical College of Wisconsin Director, Eye Institute Phone: (414) 955-2020 FAX: (414) 955-6300 E-mail: <a href="mailto:dheuer@mcw.edu">dheuer@mcw.edu</a> The Eye Institute 925 N. 87th St. Milwaukee, WI. 53226 <a href="http://www.mcw.edu/ophthalmology/faculty/FacultyProfiles1/DaleKHeuerMD.htm" rel="nofollow" target="_blank">http://www.mcw.edu/ophthalmology/faculty/FacultyProfiles1/DaleKHeuerMD.htm</a> ———————————— This episode was recorded at the West Coast Glaucoma Centre in Vancouver, BC, on November 19, 2010.  The recording gear for this episode included the Blue Microphones YETI, MacPro, Iomega SSD Flash external drive and Audio Hijack Pro software. Fission was used to convert the audio file to AIFF for Levelator to balance the sound levels. The final audio editing, chapter markers, show notes and images were put together using Garage Band ‘11 on an 11” MacBook Air. I have a lot of fun doing this by myself and recording these interviews with my colleagues. Look for more episodes as I still have another couple that are recorded that I have to edit. Opinions expressed in this podcast are those of the speakers and are not intended to be taken as the standard of care for glaucoma treatment. Please always weigh the complete clinical picture and involve patients with any decisions in their care. Robert M Schertzer, MD, MEd, FRCSC Clinical Associate Professor Dept of Ophthalmology &amp; Visual Sciences University of British Columbia <a href="mailto:podcast@iguy.org">podcast@iguy.org</a> <a href="http://iguy.tv/podcast" rel="nofollow" target="_blank">http://iguy.tv/podcast</a><a href="http://iguy.tv/" rel="nofollow" target="_blank">http://iguy.tv</a> is now set-up as a page to connect you to all my bits and bytes all over the web; go to that landing page as a convenient one-stop hub to all my activitiesWork -    <a href="http://westcoastglaucoma.com/" rel="nofollow" target="_blank">http://westcoastglaucoma.com</a> or <a href="http://iguy.tv/office" rel="nofollow" target="_blank">http://iguy.tv/office</a> Twitter - <a href="http://twitter.com/robschertzer" rel="nofollow" target="_blank">http://twitter.com/robschertzer</a> or <a href="http://iguy.tv/twitter" rel="nofollow" target="_blank">http://iguy.tv/twitter</a> Blog -     <a href="https://rob-schertzer.squarespace.com/" rel="nofollow" target="_blank">http://wholelottarob.com</a> or <a href="http://iguy.tv/blog" rel="nofollow" target="_blank">http://iguy.tv/blog</a> © Robert M Schertzer MD Inc, 2011

Ep 14 Talking About Glaucoma - 21Feb2011: New glaucoma devices with Dale Heuer (mp3)

In this episode, Dr Dale Heuer and I discuss the latest glaucoma surgical techniques and devices in search of solid evidence for their safety and effecacy. Trabeculectomy is the operation that we love to hate so we are always looking for something better. In some countries, new devices just require proving safety without having to show efficacy whereas in other countries both must be proven. Canaloplasty involves threaded a fibre-optic canula around the full circumference of Schlemm’s canal, using viscoelastic to then dilate the canal, pull a suture through to tighten it and change the canal’s position, then creating a descemet’s window before closing. The ExPress mini-shunt is a metal tube under a trabeculectomy scleral flap to create a more predictable trab. The trabectome removes the trabecular meshwork with cautery. The iStent implant is a metal snorkle creating a direct communication between the anterior chamber and Schlemm’s canal. An ER:YAG laser technique of creating direct communication between the AC and the canal has been pioneered by Dr MIchael Berlin but has still not gained traction. Other blebless techniques including the SOLEX gold plate used to create a cyclodialysis are still being tried. In the end, we still have our proven trabeculectomy as well as tube-shunt glaucoma drainage devices, both of which we have solid evidence of safetly and efficacy. As an addendum, during the show I mentioned that I was going to be performing canaloplasty in the future. I have now performed three surgeries and have three more booked for March 2011. The procedure is like angioplasty for the eye compared with a trabeculectomy or other bleb forming surgeries that are more like bypass surgeries. There is also 4 year data showing canaloplasty success with IOP lowering &gt;30% so this does show some promise as one of the new surgeries though it is technically a bit more complicated despite being less invasive than a trab. ———————————— Dale K. Heuer, MD Professor &amp; Chairman, Department of Ophthalmology Medical College of Wisconsin Director, Eye Institute Phone: (414) 955-2020 FAX: (414) 955-6300 E-mail: <a href="mailto:dheuer@mcw.edu">dheuer@mcw.edu</a> The Eye Institute 925 N. 87th St. Milwaukee, WI. 53226 <a href="http://www.mcw.edu/ophthalmology/faculty/FacultyProfiles1/DaleKHeuerMD.htm" rel="nofollow" target="_blank">http://www.mcw.edu/ophthalmology/faculty/FacultyProfiles1/DaleKHeuerMD.htm</a> ———————————— This episode was recorded at the West Coast Glaucoma Centre in Vancouver, BC, on November 19, 2010.  The recording gear for this episode included the Blue Microphones YETI, MacPro, Iomega SSD Flash external drive and Audio Hijack Pro software. Fission was used to convert the audio file to AIFF for Levelator to balance the sound levels. The final audio editing, chapter markers, show notes and images were put together using Garage Band ‘11 on an 11” MacBook Air. I have a lot of fun doing this by myself and recording these interviews with my colleagues. Look for more episodes as I still have another couple that are recorded that I have to edit. Opinions expressed in this podcast are those of the speakers and are not intended to be taken as the standard of care for glaucoma treatment. Please always weigh the complete clinical picture and involve patients with any decisions in their care. Robert M Schertzer, MD, MEd, FRCSC Clinical Associate Professor Dept of Ophthalmology &amp; Visual Sciences University of British Columbia <a href="mailto:podcast@iguy.org">podcast@iguy.org</a> <a href="http://iguy.tv/podcast" rel="nofollow" target="_blank">http://iguy.tv/podcast</a><a href="http://iguy.tv/" rel="nofollow" target="_blank">http://iguy.tv</a> is now set-up as a page to connect you to all my bits and bytes all over the web; go to that landing page as a convenient one-stop hub to all my activitiesWork -    <a href="http://westcoastglaucoma.com/" rel="nofollow" target="_blank">http://westcoastglaucoma.com</a> or <a href="http://iguy.tv/office" rel="nofollow" target="_blank">http://iguy.tv/office</a> Twitter - <a href="http://twitter.com/robschertzer" rel="nofollow" target="_blank">http://twitter.com/robschertzer</a> or <a href="http://iguy.tv/twitter" rel="nofollow" target="_blank">http://iguy.tv/twitter</a> Blog -     <a href="https://rob-schertzer.squarespace.com/" rel="nofollow" target="_blank">http://wholelottarob.com</a> or <a href="http://iguy.tv/blog" rel="nofollow" target="_blank">http://iguy.tv/blog</a> © Robert M Schertzer MD Inc, 2011

Ep 14 Talking About Glaucoma - 21Feb2011: New glaucoma devices with Dale Heuer (AAC Enhanced)