Like a piece of misapplied scotch tape that gets bunched in the middle, a macular pucker is a fold in the retina precisely where it is least wanted—the very heart of the retina, where fine detail is resolved. James Handa, M.D., the Robert Bond Welch, M.D., Professor of Ophthalmology and the newly seated chief of the Retina Division at Wilmer, says that state-of-the-art surgery can correct the problem. Aided by sophisticated surgical equipment, Wilmer surgeons can grab the membrane, peel it back and pull it flat again to improve vision. It is a delicate and complex surgery.
As impressive as the procedure is, this sort of cutting-edge capability does not always garner the attention it deserves, says Handa. As chief of the division and as a surgeon, Handa wants to change that.
The Wilmer Retina Division is the largest division at Wilmer with 19 full-time faculty members and as many as 300 patients seen each day. The division is well-known and highly regarded for its exceptional clinical care, cutting-edge research and success at treating a remarkable array of conditions ranging from age-related macular degeneration to ocular malignancies.
While many of those treatments involve surgeries of great skill and expertise, surgery is not always the first thing that comes to mind when speaking of Wilmer’s Retina Division. In his new role as division chief, Handa sees his priority as maintaining Wilmer’s high standing in all aspects of retinal care while substantially raising the profile of its surgical practice, which he says is as good as any in the world.
“There is not a surgical or medical retinal condition that we cannot treat with the highest degree of confidence,” Handa notes. “We need to raise awareness—the consciousness—of the incredible skill and capabilities available here.”
“Jim Handa is an extremely successful clinician and recognized scientist in retina, as well as a cardcarrying retina surgeon,” says Neil Bressler, M.D., the James P. Gills Professor of Ophthalmology and the outgoing division chief, who served in the role for the past 13 years. “He is one of a handful in the world with the experience to lead this division into the future.”
That future, Handa believes, will be more focused on surgery. Among the areas of Wilmer’s practice that he feels deserve more attention is robotic surgery, where Peter Gehlbach, M.D., Ph.D., is one of the world’s foremost experts.
Handa himself is no stranger to robot-assisted eye surgery. He worked with Russ Taylor, Ph.D., of the Johns Hopkins Whiting School of Engineering— known as the father of robotic surgery—to develop machines that guide the surgeon’s hands while performing finely detailed surgeries on retinal tissues—some of the smallest and most delicate tissues in the human body. Incisions are smaller. Patients heal faster. Often, there is little need even for pain medications following such surgeries, Handa says.
“We’re really trying to change how people think about eye surgery,” Handa says.
Bressler welcomes the increased focus on surgery and sees the added emphasis as a natural evolution that builds on the division’s recognized strengths.
“Jim brings a wonderful, fresh perspective to things,” he says.
Another area of surgical expertise that merits attention, Handa says, is Wilmer’s success with the Argus® II retinal prosthesis that is restoring a certain measure of sight to the blind. Some have called it a bionic eye.
The Argus II involves wearing what looks like a pair of performance sunglasses, on which a small digital camera is mounted. A video processor relays signals from the camera to a chip implanted in the patient’s eye. That chip is wired to the optic nerve and the brain. Working together, this system restores a modicum of vision that allows navigation of the world without assistance. Wilmer is a leader in eye prostheses, Handa says—he and Fernando Arevalo, M.D., the Edmund F. and Virginia Ball Professor of Ophthalmology, are two of a small number of surgeons in the world to have successfully performed the Argus chip implantation.
In other emerging areas of opportunity, Handa points to the promise of regenerative medicine. He says the work of Wilmer faculty members, like Mandeep Singh, M.D., Ph.D., with stem cell implants to counter genetic vision conditions represents the future of retinal surgery. Elsewhere, in a relatively new dimension of Wilmer’s surgical offerings, Kim Jiramongkolchai, M.D., has initiated a surgical practice specifically targeted to children, while Zelia Correa, M.D., Ph.D., the Tom Clancy Professor of Ophthalmology, is a specialist in both pediatric and adult eye cancers, which often require surgery.
“These are all state-of-the-art procedures that we need to start bragging about—and we will!” says Handa.