About the Guest(s):

Dr. Richard Dortzbach: A pioneering figure in oculofacial surgery, Dr. Richard Dortzbach, affectionately known as “Dortz,” was the first fellowship-trained oculoplastic surgeon at the University of Wisconsin - Madison. Over his illustrious career, he trained 19 fellows and significantly influenced the field through his contributions to both clinical practice and education. Notably, Dr. Dortzbach held the Pa Noh professorship at UW-Madison and served in numerous leadership roles within the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS), including President in 1995.

Dr. Mark Lucarelli: Dr. Mark Lucarelli is an esteemed colleague of Dr. Dortzbach and his final fellow. He has continued the tradition of excellence in oculofacial surgery as a distinguished member of the UW-Madison faculty. Dr. Lucarelli is highly respected for his contributions to both patient care and the education of future oculoplastic surgeons. He has been an ASOPRS fellowship program director since 2005 and served as President in 2020.

Dr. Suzanne van Landingham: Dr. Suzanne van Landingham is an assistant professor of oculofacial surgery at UW-Madison and a former fellow of Dr. Lucarelli. She plays a vital role in ongoing educational efforts and upholding the high standards set by her predecessors.

Episode Summary:

In this insightful episode of TOP (The Oculofacial Plastic Surgery podcast), Dr. Mark Lucarelli and Dr. Suzanne van Landingham sit down with Dr. Richard Dortzbach, a towering figure in oculofacial surgery. They delve into Dr. Dortzbach’s impactful career, exploring his journey as the first fellowship-trained oculoplastic surgeon at the University of Wisconsin - Madison and his extraordinary dedication to teaching and patient care.

From pioneering procedures dating back to the times of Hammurabi to the modern-day complexities of oculoplastic surgery, Dr. Dortzbach discusses the evolution of the specialty. The conversation highlights key milestones such as the establishment and growth of ASOPRS and the invaluable legacy left through his fellowship program. The episode offers a wealth of insights into educational excellence, mentorship, and the profound impact of Dr. Dortzbach’s work on numerous generations of surgeons.

Key Takeaways:

• Evolution of Oculoplastic Surgery: Dr. Dortzbach shares compelling anecdotes about the specialty’s origins,

• including significant contributions from early pioneers and the formalization of ASOPRS.

• The Importance of Fellowship and Mentorship: Emphasizing continuous learning and teaching, Dr. Dortzbach underlines the value of fellowship training and how it has shaped the landscape of oculofacial surgery.

• Scientific Contributions and Publications: Dortz discusses his most impactful research and educational materials, including his seminal textbook and the prestigious White Coat Society.

• Lessons and Aphorisms: Dr. Dortzbach’s pearls of wisdom, such as the necessity of patient-centered care and his distinctive mottos that continue to influence his trainees.

• Balancing Professional and Personal Life: Insights into maintaining a work-life balance and the importance of family and personal milestones in a demanding medical career.

Notable Quotes:

1. Dr. Richard Dortzbach: “The most important thing is to always focus on the patient.”

2. Dr. Mark Lucarelli: “Dortz, you really established the concept of “fellowship family”.”

3. Dr. Richard Dortzbach: “Commitment only, no lip service.”

4. Dr. Suzanne van Landingham: “You’ve also done a lot to foster community in your fellowship graduates.”

5. Dr. Richard Dortzbach: “Education in all aspects is really the key for trainees.”

Resources:

• ASOPRS Website

If you're an ASOPRS Member, Surgeon or Trainee and are interesting in hosting a podcast episode, please submit your idea by visiting: asoprs.memberclicks.net/podcast

In this insightful episode of The Oculofacial Podcast, Dr. Christy Nelson sits down with Dr. Sara Wester and Dr. Parag Gandhi to discuss the exciting and rewarding world of global outreach in oculoplastic surgery. This episode delves into personal narratives from their international experiences, the impact of their work, and the comprehensive efforts led by the ASOPRS Global Opportunities Committee in making oculoplastic care accessible worldwide.

Listeners will discover how Dr. Wester and Dr. Gandhi first got involved in global health initiatives and the profound personal and professional impacts of these experiences. From overcoming logistical challenges to the joy of teaching and learning in diverse cultural settings, the episode is packed with rich, first-hand insights and practical advice. They also discuss current projects, partnerships like the Honduras fellowship with ACE Global, and provide actionable tips for those interested in starting their own global outreach work.

Key Takeaways:

• Getting Started in Global Outreach: Dr. Wester and Dr. Gandhi stress the benefits of starting on a smaller manageable scale and leveraging existing connections and organizations for initial trips.
• Impact of International Work: Personal stories highlight how global outreach can be both humbling and empowering, offering unique opportunities to learn and teach.
• Specific Challenges: Overcoming hurdles such as varying medical equipment availability, cultural differences, and adapting to different surgical environments.
• Sustainable Programs: Both doctors emphasize the importance of education and creating sustainable programs that continue to benefit communities long-term.
• Global Opportunities Committee: The committee’s efforts in providing resources, networking opportunities, and structured programs for ASOPRS members interested in international outreach.

Notable Quotes:

• “I’ve always kind of loved feeling a little bit out of my comfort zone and these opportunities push me in unique ways.” - Dr. Sara Wester
• “Outreach doesn’t always have to be overseas. One can work locally with nonprofits like Lions International to develop programs for the underserved in state.” - Dr. Parag Gandhi
• “ I’ve also seen gratitude in these experiences that is truly unique” - Dr. Sara Wester
• “One should note there are many reasons to get interested in international work. It’s really kind of a very individual driver.” - Dr. Parag Gandhi
• “You have to adapt to different surgical environments, different equipment, and different team structures.” - Dr. Sara Wester

Resources:

• Virtue Foundation: Website
• Orbis International: Website
• Seva Foundation: Website

If you're an ASOPRS Member, Surgeon or Trainee and are interesting in hosting a podcast episode, please submit your idea by visiting: asoprs.memberclicks.net/podcast

Podcast Guests:

Dr. Evan Kalin-Hajdu - Assistant Professor of Ophthalmology at the University of Montreal. Dr. Kalin-Hajdu is the host of the current "Oculofacial Podcast Journal Club".

Dr. Bryan J. Winn - Professor of Ophthalmology and Vice Chair and Division Director for Oculofacial Plastic Surgery at UCSF. He also serves as the Chief of Ophthalmology at the San Francisco VA Healthcare System.

Dr. Davin Ashraf - Assistant Professor of Ophthalmology at Oregon Health & Science University (OHSU).

Dr. Kyle J. Godfrey - Assistant Professor of Ophthalmology at Weill Cornell Medicine and the New York Presbyterian Hospital. He is also the Director of the Ophthalmology Residency Program and a member of the Departments of Ophthalmology and Neurological Surgery.

Episode Summary:

Dr. Evan Kalin-Hajdu is joined by Dr. Bryan J. Winn, Dr. Davin Ashraf, and Dr. Kyle J. Godfrey to discuss three key articles from the May-June 2024 issue of the Ophthalmic Plastic and Reconstructive Surgery (OPRS) journal. Their discussions center on short-term versus long-term results of teprotumumab, a more tailored approach to the management of thyroid eye disease, and the nuances of increasingly popular transorbital surgery.

Dr. Winn begins by summarizing an article on teprotumumab for recalcitrant thyroid eye disease. The panelists then discuss the strengths and weaknesses of the paper, highlighting the medication’s short-term effectiveness but raising concerns about its long-term durability. Dr. Ashraf then provides insights into a study that compared teprotumumab versus orbital decompression for thyroid eye disease, highlighting the likely additive effects of these combined treatments, but also raising compelling points about regression of proptosis that was only observed in the teprotumumab group. Dr. Godfrey then wraps up with an in-depth look at a novel transorbital endoscopic approach to the foramen rotundum for infraorbital nerve stripping, emphasizing the technique's potential utility, risks, and anatomical considerations.

Key Takeaways:

• Teprotumumab demonstrates significant short-term (3 weeks post treatment) efficacy in reducing proptosis and clinical activity scores in recalcitrant thyroid eye disease. However, data on long-term durability in this cohort remains unknown.
• Combining teprotumumab with orbital decompression may provide additive benefits for proptosis reduction. Surgical decompression provides the greatest proptosis reduction and does not appear to regress in time. However, patients treated solely with teprotumumab appear to regress within months of therapy.
• The participants discuss a more evidence-based approach to the management of thyroid eye disease, shifting away from the “one size fits all” model. The approach involves an effective short-term disease modulator, such as teprotumumab, followed by a more effective long-term disease modifier, such as tocilizumab or radiation therapy.
• Introducing a transorbital endoscopic approach for infraorbital nerve stripping could expand the surgical arsenal for managing complex orbital and perineural pathologies.