Years of work, effort culminate in Holland Foundation for Sight Restoration
My commentary on the Holland Foundation for Sight Restoration will be more personal than usual. At the outset, I will disclose that I am a strong advocate for what Edward Holland, MD, is doing for a difficult to manage, significantly visually handicapped and undertreated group of patients. I have agreed to serve on the Holland Foundation for Sight Restoration board of directors and am committed to contribute both time and money.
I have worked with, watched and encouraged Ed Holland as he committed to work on developing effective treatments for the patient with severe ocular surface disease associated with limbal stem cell deficiency and for those who require high-risk keratoplasty. Ed was an ophthalmology resident at the University of Minnesota when I was director of the cornea service. I picked him out as special while he was a first-year resident and recruited him aggressively for a career in ophthalmology focused on the cornea. I offered him a position, with the support of my chairman, the late Donald J. Doughman, MD, on the University of Minnesota Cornea Service following his training while he was a second-year resident. In particular, I encouraged him to think about focusing on the management of high-risk keratoplasty, often associated with severe ocular surface disease and limbal stem cell deficiency, as it was one of the most difficult patient management problems I faced every day in my practice. After several decades of a cornea-focused department of ophthalmology in Minnesota, we had hundreds of these extraordinarily challenging patients on our service.
After his residency training in Minnesota, Jay Krachmer, MD, accepted Ed for the outstanding cornea fellowship at the University of Iowa. After a year at Iowa, Ed was ready to come home to Minnesota and get to work, but I persuaded him to spend another year working at the National Eye Institute with Robert Nussenblatt, MD, MPH, at that time the top ophthalmic immunologist in the world. After his second year of fellowship training at the NEI, Ed returned to the University of Minnesota department of ophthalmology and from day 1 was challenged by a large cohort of patients with severe vision loss from failed keratoplasty, severe ocular surface disease and limbal stem cell deficiency. Ed more than accepted the challenge: He embraced it and thus began three decades of work that have led him to become a top authority in the world managing these difficult patients.
At the University of Minnesota when Ed joined the faculty, we were blessed with a very strong solid organ transplant program led by John Najarian, MD, the chairman of surgery, and a top-notch clinical immunology group led by Robert Good, MD, PhD. Ed took full advantage of these experts and learned that significant long-term immunosuppression was as critical as skilled surgery in managing these difficult patients. Ed later moved his practice to the Cincinnati Eye Institute and the University of Cincinnati where he continued his groundbreaking work.
Ed has shown us that management of these difficult patients is possible, but it requires a team of providers. A committed and skilled corneal surgeon is essential, but a renal service highly experienced in the management of immunosuppression regimens similar to those required for kidney and other solid organ transplants is equally important. To coordinate the care, a dedicated and skilled transplant coordinator is critical.
It is a labor of love to care for patients such as these, as adequate reimbursement is lacking, and many patients are poor and require philanthropy to support travel for surgery, follow-up, medications and laboratory testing. Experienced industry veteran Robert Dempsey, St. Elizabeth Healthcare where Ed operates in rural Kentucky, a growing cohort of friends led by Bob Sathe and several committed ophthalmologists have stepped forward under Ed’s leadership to make the so-called “Cincinnati procedures and treatment approach” more widely available in select institutions nationwide. It takes a village to make this effort a success and sustain it. If this opportunity to make a difference resonates with you, please contact Robert Dempsey at firstname.lastname@example.org and express your interest. Together, we can make the lives of thousands of our fellow Americans better.
Disclosure: Lindstrom reports he is on the board of directors for the Holland Foundation for Sight Restoration and on the board of directors for and equity owner of Minnesota Eye Consultants and Unifeye Vision Partners.