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Glaucoma/Anterior Segment Fellowship

Tulane Glaucoma Fellowship Program (TGFP)

TGFP is an AUPO certified one-year fellowship program designed to train ophthalmologists in the art and science of glaucoma. The program is open to one fellow per year. All applicants must apply through the San Francisco Matching Program.

Position available: 1

Locations

  • Tulane Medical Center
  • Southeast Louisiana Veterans Health Care System (SLVHCS)
  • University Hospital

All above sites are located in downtown New Orleans, within walking distance of each other.

Satellite Clinics

  • Eye Associates of West Jefferson, Marrero, LA
  • Alexandria VA Health Care System, Alexandria, LA
Faculty

Fellowship Director: Ramesh S. Ayyala, MD, FRCS, FRCOphth

Southeast Louisiana Veterans Health Care System, New Orleans: Jared Vincent, MD (Fellowship-trained Glaucoma/Anterior Segment)

VA Alexandria: Candace Collins, MD (Fellowship-trained Pediatric/Comprehensive)

University Hospital: Peter Kastl, MD, PhD (Fellowship-trained Cornea/External Disease)

Clinical Expectations

The fellow is expected to attend all the glaucoma clinics run under the supervision of the Tulane Glaucoma Service. This includes the weekly glaucoma clinics at Tulane Medical Center, Eye Associates of West Jefferson, as well as the Southeast Louisiana Veterans Health Care System. The fellow is also expected to staff monthly glaucoma clinics at the University Hospital and the VA Health Care System in Alexandria.Read More

The fellow is expected to participate in at least 6,000 patient visits during the year, perform 150+ glaucoma related procedures, review more than 1000 HVF/OCT/Pentacam topographical images of the cornea, fulfill call obligations, attend grand rounds, journal clubs and other resident teaching activities, as well as participate in the online glaucoma international lecture series.

The fellowship offers exposure to patients with a wide variety of glaucoma-related pathology such as glaucoma suspects, ocular hypertension, primary open angle glaucoma, secondary open angle glaucoma (pigmentary, pseudoexfoliative and steroid), uveitic glaucoma, acute and chronic angle closure glaucoma, neovascular glaucoma, glaucoma associated with retinal and corneal diseases, congenital glaucoma, and glaucoma associated with systemic disorders. In addition, fellows gain experience with a variety of complex cataract and other anterior segment pathology.

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Laser

Fellow is taught the indications, and will perform over 40 laser procedures including Selective Laser and Argon Laser Trabeculoplasty, YAG laser iridotomy, and Argon laser iridoplasty.

Surgery

The fellow is expected to participate in surgery at Tulane, both VA hospitals, and University Hospital. The fellow has a wide variety of surgical exposure, and will become proficient in the surgical management of different glaucoma treatment options including trabeculectomy with and without anti-fibrotic agents, bleb revision for leaky blebs and hypotony maculopathy, management and drainage of choroidal effusion and hemorrhage, management of failing bleb, implantation of Ex-Press mini shunt implantation and glaucoma drainage devices, performance of canal-based surgeries such as canaloplasty and iStent implantation. The fellow gains experience in performing combined glaucoma and cataract surgery, complex cataract surgery, as well as management of corneal pathology in association with glaucoma including penetrating keratoplasty and Deep Stromal Automated Endothelial Keratoplasty (DSAEK). The fellow will be able to primarily assist in the management of congenital glaucoma including goniotomy, trabeculotomy-trabeculectomy and glaucoma drainage devices, cyclodialysis cleft repair, and cyclo-destructive procedures.

Surgical Experience of Previous Fellows

  • 150 + as primary surgeon (200 + assists)
  • Ahmed Glaucoma Valve: 45
  • Baerveldt Glaucoma Implants: 15
  • Trabeculectomy and Ex-Press mini shunt: 25
  • Canal based surgery (iStent 15, Canaloplasties 10; Goniosynechiolysis 10)
  • Cataracts: 45
  • The fellow assists in a variety of anterior segment reconstruction surgeries associated with glaucoma surgery.
Slit lamp procedures

During the fellowship, emphasis is placed on performing a wide variety of procedures at the slit lamp. The fellow will assist as well as primarily perform needling of failing bleb, suturing of a leaky bleb, compressive sutures for the management of large blebs, barrier sutures to restrict the bleb spread, trans-conjunctival scleral flap sutures in the management of hypotony, anterior chamber reformation, peripheral synechialysis, and astigmatic keratotomy at the slit lamp.

Research

The fellow is expected to take part in the ongoing glaucoma-related research in the department. The research involves both basic science and clinical (both animal surgery and human studies). It is expected that the fellow presents the research at the Tulane annual research day (O’Brien Professorship), and submit the research at national conferences such as ARVO, AGS and AAO meetings.

Research Director: Diane Blake, PhD

Current Research

  • GLASS (Glaucoma Slow release drug delivery System )- drug coated glaucoma drainage implant using slow release Mitomycin C device.
  • Surgical outcomes of various glaucoma procedures
  • Corneal endothelial decompensation and glaucoma
Teaching

The fellow is expected to take part in the innovative, on-line teaching using the MediTred® platform. Dr. Ayyala is the President of MediTred®, which he founded in 2011. Sample lectures may be viewed on YouTube. (https://www.youtube.com/channel/UCuBcmtHFrNSJ6mHFFS4tQPQ)

International Rotation (optional)

Dr. Ayyala has helped establish the Anand Eye Institute (AEI) in Hyderabad, India in 2012. He is Chairman, and sits on the Board of Directors for AEI. The fellow has the opportunity to travel to AEI and gain surgical experience. (http://anandeyeinstitute.org/)

Past TGFP Fellows
Analisa Arosomena, MD alisa72@hotmail.com
Julie Foreman, MD

julielark@yahoo.com

Winston Garris, MD wjgarris@gmail.com
Mathew George, MD mattkg@gmail.com
Amy Hong, MD amy4729@hotmail.com
Mirela Krasniqi, MD

krasniqi@buffalo.edu

Jeff Maehara, MD sciaenops@hotmail.com
Jared Vincent, MD

jared.vincent@va.gov