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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. Ryan April 30, 2010 Durham, NC. Robert Machemer. Visionary Creative Father of vitrectomy Courage – first cases Engineering and Medicine Bascom Palmer and Duke Teacher, colleague, and friend.

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ROBERT MACHEMER: A PIONEER IN VISION Duke Eye Center Stephen J. Ryan April 30, 2010 Durham, NC

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  1. ROBERT MACHEMER: A PIONEER IN VISION Duke Eye Center Stephen J. Ryan April 30, 2010 Durham, NC

  2. Robert Machemer • Visionary • Creative • Father of vitrectomy • Courage – first cases • Engineering and Medicine • Bascom Palmer and Duke • Teacher, colleague, and friend

  3. Creativity vs. Problem Solving Novel Simple Elegant Effective Generative

  4. Robert Machemer • Opened the Vitreous Space • Vitreo Retinal Surgeons • Endo Surgery • Intraocular and Other • Pathogenesis of R.D.

  5. Vitreous Surgery • Opened whole new field • Educated many trainees  Future Leaders • Generous with his time and encouragement • Stimulated ideas • Encouraged Critical Thinking

  6. Research Influenced by Robert Machemer • Vitreous Surgery – Clinical and Research • Pathogenesis of Retinal detachment • Rhegmatogenous • Traction • Translational research  patients • Many other areas

  7. Clinical Research Animal Research Clinical Observations Clinical Practice Laboratory Research

  8. Penetrating Ocular Injuries • Trauma model • Penetrating injuries – more detachments than blunt injuries • Penetrating injuries alone  no R.D. • Blood alone  no R.D. • Injury + Blood  R.D.

  9. TRACTION RETINAL DETACHMENT • WOUND HEALING

  10. Clinical Management • Rhegmatogenous R.D. • After penetrating injury, two rows of 360 extensive cryotherapy to prevent RRD • Huge additional inflammatory stimulus • After Vitrectomy – different Rx • Vitrectomy Remove stimulus to inflammation and wound repair

  11. Final Common Pathway Abnormal Vitreous Breakdown of Blood Retinal Barrier Migration Proliferation Contraction Traction Detachment Trauma PVR PDR

  12. PATIENT CLINICIAN BASIC RESEARCH IDEA TRANSLATIONALRESEARCH COMMERCIALIZATION CLINICALRESEARCH

  13. Robert Machemer • Visionary • Creative • Father of vitrectomy • Bascom Palmer and Duke • Teacher, colleague, and friend PIONEER

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