5 Questions with Rudy M. M. A. Nuijts, MD, PhD

1. What technologies do you feel will most impact vision in the future?
High rates of astigmatism and incomplete wound healing have plagued corneal transplantation surgery. As one of the first surgeons in Europe to be involved in clinical trails on the femtosecond laser, I am extremely interested to see an improved method replace the current technology. I believe these femtosecond lasers could usher us into a new era of customized cornea ablations, with better wound healing, and lower levels of astigmatism. This technology could not only revolutionize perforating keratoplasty, but I believe we will be able to make smoother cuts of the lamellar interface in lamellar transplantation surgery: We will see a better quality of vision as an end result.

Down the road, I think we will see a further evolution of toric and phakic multifocal lenses, and a revival of intracorneal lenses.

2. What is the focus of your current research?
I am running two multicenter, randomized, clinical trials in the Netherlands, comparing perforating keratoplasty and femtosecond laser assisted posterior-lamellar keratoplasty, and another trial comparing deep anterior lamellar-keratoplasty versus conventional perforating keratoplasty. We are particularly interested in examining patient satisfaction and quality of vision. I believe that it is just as essential to examine what the patient experiences, as techniques, outcomes, and the parameters of surgery.

I am also interested in finding better sustained drug delivery methods. We now have discovered many ophthalmic drugs —but we need to find more effective ways, like transscleral drug delivery, to bring them into the eye.

3. What is one of your proudest past career accomplishments?
At the start of my career, almost no one was examining patient satisfaction in ophthalmology. When I came to Academic Maastricht Hospital in the Netherlands, we started examining the satisfaction of multifocal patients versus monofocal patients, and comparing satisfaction of cataract surgery outcomes at an academic hospital versus a general hospital, or an ambulatory center. That was really a new direction—since before that, surgeons where always pretty convinced of themselves and their results.

Now, studies on patient satisfaction may be found throughout every ophthalmic subspecialty and are requested by government and consumer agencies.

4. Who are your role models?
I am particularly indebted to Adrian C. Breebaart, MD, PhD; Erik L. Greve, MD, PhD; W. Houdijn Beekhuis, MD; and Gabriel van Rij, MD, PhD, for stimulating my career.

My scientific mentor was Hank Edelhauser, PhD, of Emory Eye Center, in Atlanta. As a resident at the Academic Medical Center in Amsterdam, we were seeing patients with corneal decompensation after cataract surgery. Dr. Edelhauser was traveling through Europe at this time, and offered to bring me to his lab in Milwaukee to find the cause of this—which we later discovered to be originating from detergent remnants in the reusable cannulas. This mechanism is now widely recognized as one of the causes of TASS.

That was the beginning of my scientific career; I eventually went back to finish my PhD with him in Atlanta.

Jan Worst MD, from Groningen Netherlands, showed me that although it might take some effort, if you are perseverent, you can achieve you goals.

My current boss, Fred Hendrikse, MD, PhD, is also a man of great perseverance and an excellent manager. He was able to build a large academic group of talented ophthalmologists and keep them on track, despite the bureaucracy out there.

5. What do you hope to accomplish in the future of your career?
I hope we will be able to improve the role of technology in corneal transplants surgery. I hope to achieve better outcome in transplantation surgery with the femtosecond laser, so that we end up with more satisfied patients.