Dr. Terry Kim provides his perspective on the 2008 ASCRS meeting in an interview with contributing editor, Dr. Parag Majmudar. High points of the meeting included the wet-labs, film festival and of course, "The Challenge Cup Series" combining education and entertainment. Dr. Kim describes the instructional courses on tissue adhesives that he's been developing with Chris Rapuano, David Ritterband, Herb Kaufman, Richard Copeland, David Hardten, and Sadeer Hannush. Applications of surgical adhesives in ophthalmic surgery include cyanoacrylates for corneal perforations and cataract incisions. Fibrin sealants are used in pterygium (conjunctival autografts and amniotic-membrane transplants) and LASIK complications such as epithelial ingrowth. All adhesives are used off-label, so Dr. Kim has been involved in creating a new adhesive specifically for ophthalmic use: HyperBranch's OcuSeal. Advantages are that it cross-links in 30 seconds, is easy to apply, and provides a microbial barrier as shown by Dr. Francis Mah.
Video: Dr. Terry Kim Discusses Surgical Adhesives in the Context of Ophthalmic Surgery
Dr. Parag Majmudar Interview with Dr. Terry Kim
Dr. Parag Majmudar: Hi, I'm Dr. Parag Majmudar from Chicago Cornea Consultants and Rush University Medical Center in Chicago.
Today, we're spending time with Dr. Terry Kim, world-renowned cornea and refractive surgeon, Associate Professor of Ophthalmology at Duke University Eye Center. Dr. Kim, thank you for joining us and taking time out of your busy schedule.
What would you say has been the highlight of your involvement in the ASCRS? What's the most exciting or informative session you've been a part of?
Dr. Terry Kim: Well, I always like the ASCRS meeting for a number of reasons. I mean, the film festival is a big attraction for many folks. In addition, the format of having instructional courses, skill-transfer courses or wet labs that are open to the public, there's no additional fees that are necessary, so it's a wonderful meeting in terms of having access to all these things. And I do think that the meeting has a tendency to really highlight cutting-edge technology in all different fields, you know, cataract, cornea, refractive.
So, to me, one of the, I think, more exciting events that hasn't taken place yet, but will on Tuesday, is the Challenge Cup. I think many folks who have been to ASCRS will remember this event, and they're familiar with it, obviously, from the last several years it's been running.
This year, I am the captain of the refractive team, and actually, Parag, you are obviously a member of that. And what was interesting going through the process was really trying to get some key educational points across to the audience, but, at the same time, making it entertaining. And the beauty of that was finding talents in people that you never knew were there, and that--.
Dr. Parag Majmudar: --I think we've done that.
I know one of your research interests or your area of focus is tissue adhesives and novel use of tissue adhesives.
Dr. Terry Kim: Um-hmm.
Dr. Parag Majmudar: Tell me what you're doing new in that regard.
Dr. Terry Kim: Well, we've been running an instructional course over the last several years, both at ASCRS and AAO, on innovative uses of adhesives for a wide variety of conditions. Myself, Dr. Chris Rapuano, Herb Kaufman, David Ritterband, Richard Copeland, David Hardten, and Sadeer Hannush cover a pretty wide array of topics in terms of unique applications of adhesives. And it's great to see that over the last several years this course has really been gaining in popularity because I do think that people are looking now to an alternative way of closing wounds in general.
So, we discussed using cyanoacrylate adhesives, for example, for sealing corneal perforations, as well as cataract incisions, and using fibrin-based adhesives for pterygium surgery, specifically with conjunctival autografts and amniotic membrane transplants, as well as for treating LASIK complications, such as epithelial ingrowth.
Myself, I've been involved with developing a new adhesive specifically tailored for ophthalmic use. As you know, tissue and cyanoacrylated adhesives are used on the eye off-label. So, they have a lot of disadvantages, such as cyanoacrylate, which is very abrasive, it's toxic on the eye and it's uncomfortable, so bandaged contact lenses are frequently required to seal adhesives, are costly, and you can have risk of infection, and the preparation process is long.
So, for instance, with cataract surgery and the concern about the potential increased rates of endophthalmitis with clear corneal incisions, I think there is a role here for a new adhesive, such as the one we've been developing for ophthalmic use. It is approved in--outside of the United States. It obtained CE mark in December, and a company named HyperBranch Medical Technology is marketing it under the trade name OcuSeal.
And it's a very unique applicator system where you just puncture the glass vial, and then you just paint it on with a brush applicator system onto the ocular surface. It cross-links within 30 seconds; very quick and easy and convenient to use, which is, I'm sure, what cataract surgeons want in looking at this. And it provides a barrier, and we've shown some microbial barrier properties. Francis Mah has helped us with some of those studies.
So, I think it's attractive and, again, a paradigm shift for having something that will be very conducive to the eye. It's biodegradable, biocompatible, and it's very easy to use. It's transparent, it's soft, it's elastic, so I think it provides a lot of unique properties that will hopefully make it popular for ophthalmic use.
Dr. Parag Majmudar: Yeah, it sounds like an ophthalmic-specific tissue adhesive would have very many broad applications, maybe some that we haven't even thought of yet.
Terry, thank you very much for taking time out of your schedule to be with us and enlighten us about your many varied research interests.
Dr. Terry Kim: Thanks.
Dr. Parag Majmudar: For more information, please click on the links below.