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In Remembrance

2011; Lippincott Williams & Wilkins; Volume: 37; Issue: 11 Linguagem: Inglês

10.1016/j.jcrs.2011.09.025

1873-4502

Nick Mamalis, Emanuel Rosen, Douglas D. Koch, Thomas Kohnen, William J. Dupps, Stephen A. Obstbaum,

Intraocular Surgery and Lenses

Figure: David J. Apple, MDDavid J. Apple, MD, 69, passed away in August 2011 following a long and difficult battle with the many side effects of radiation therapy for throat cancer. David was a renowned ophthalmic pathologist and a pioneer in research of the pathology of intraocular lens (IOL) complications as well as cataract surgery in general. David received his undergraduate training at Northwestern University, followed by medical school at the University of Illinois. His initial residency training was in the field of pathology, and he then obtained additional training in ophthalmic pathology and rose through the academic ranks in this area at the University of Illinois Eye and Ear Infirmary. David completed his residency in ophthalmology at the University of Iowa as a professor of ophthalmic pathology. David’s background as an ophthalmic pathologist in addition to his training in ophthalmology gave him the background to pursue the complications associated with early IOLs. Prior to David’s establishment of the Center for IOL Research at the University of Utah with Randall J. Olson, MD, there was no center available to study explanted IOLs and to evaluate IOL designs, materials, and finishes. David was instrumental in legitimizing the work of Sir Harold Ridley on the first IOL, and his textbook on Mr. Ridley is a fascinating study of the history of the IOL in general. David received multiple honors during his career. He presented the prestigious Binkhorst lecture and the Kelman Innovator’s talk at the American Society of Cataract and Refractive Surgery (ASCRS) and received a Life Achievement Award from the American Academy of Ophthalmology. The high point of David’s career was being named to the ASCRS Ophthalmology Hall of Fame. David touched the lives of countless ophthalmologists, including the editors of the JCRS. FROM EMANUEL ROSEN, MD, CO-EDITOR David Apple was already a major figure in ophthalmology when I met him in 1987. I was an enthusiastic cataract and lens implant surgeon and was captivated by his insights into the pathophysiological processes of lens implantation. He was so friendly and approachable that I developed an instant and enormous liking for the person he was. He was helpful and always an inspirational figure. We spent many times together on a one-to-one basis, first in Manchester at the inaugural viscoelastic device meeting, where he was supportive of my antipathy to impure methyl cellulose then being used in famous institutions to save investment in Healon (sodium hyaluronate), the relatively new but proven to be savior of so many eyes having cataract and lens implantation surgery. I had further good fortune to spend time with David in Berlin, where we toured the then-infamous Berlin wall and, perched on a ladder, cautiously peeked over the top of the wall into East Berlin, and subsequently in Hong Kong and at many meetings of the European Society of Cataract and Refractive Surgeons (ESCRS) and the International Intraocular Implant Club (IIIC). David was a serious and contributing member of both IIIC and ESCRS, where his regular and brilliant contributions enlightened all of us who took to heart his innovations and advice. Together with his wife Ann, David was present at many meetings, where he seemed to take the massive travel schedule in stride even after his throat cancer when he coped with the after effects of treatment in an uncomplaining fashion, drawing the admiration of all who knew him. Like all ophthalmologists I know, he will be much missed but never forgotten for the better ophthalmic world he leaves behind thanks to his outstanding contributions. FROM DOUGLAS D. KOCH, MD, EDITOR EMERITUS David Apple was an innovator and pioneer who literally invented a new field: the pathology of ophthalmic devices. I first met David in the early 1980s, when he was building his program at Utah with the prescient support of Randy Olson. It was obvious then that David recognized a huge gap in our understanding of the pathology of lens implants and indeed of contemporary cataract surgery. David is undoubtedly responsible for saving thousands of eyes and improving the outcomes of many more. He helped us understand interactions among materials, design, procedures, and anatomy, and these insights fostered the development of better lenses and better surgery. David was also deeply interested in ophthalmic history. His efforts to bring recognition to Harold Ridley were at least partly responsible for Ridley being knighted, and it enriched our field by educating us in the origins of lens implant surgery and the struggles of these courageous colleagues. David had a wonderful enthusiasm for his work and a warm and engaging personality. He was deeply inquisitive and constantly challenged those around him with his ideas and his own unanswered questions. An inveterate traveler, David educated ophthalmologists—and he and Ann made close friends—around the globe. His legacy lives in what he taught us, and in the tradition of ophthalmic device pathology that now flourishes because of his efforts. NICK MAMALIS, MD, CO-EDITOR When I decided to go into ophthalmology, members of our ophthalmology department suggested working with an ophthalmic pathologist named David Apple, who would be joining the University of Utah faculty. When David suggested that I consider a pre-residency fellowship in ophthalmic pathology, I readily accepted. The early 1980s were an era of great innovation in the area of cataract surgery and IOL development. New IOL designs and materials were continually being introduced. Unfortunately, complications associated with IOLs were also beginning to appear. Surgeons would remove IOLs that were causing complications and simply toss them into the drawer. There was no central laboratory to analyze these complications, and David immediately recognized the great need for such a facility. He established the Center for IOL Research at the University of Utah with Randy Olson. It was an exciting time to be a fellow involved on the ground floor of the development of this endeavor. David’s extensive pathology background, as well as his ability to distill large amounts of information, was perfect for the director of this center. David was instrumental in getting the word out to ophthalmic surgeons to send their explanted IOLs and complicated cases to the IOL Research Center for analysis. This work resulted in the first major review article on IOL complications, and David truly became the world’s authority in this field. I was a charter member of the original “Apple Korps,” which was the group of David’s ophthalmic pathology research fellows. David nurtured the development of the careers of many young fellows from around the world. He was a wonderful mentor and helped to develop my early career in the field of IOL research and IOL complications. David had an innovative mind and was a great teacher. His research work in the areas of IOL complications led to the development of newer and safer IOL designs, finishes, and materials, which we use to this day in cataract surgery. David’s legacy is a large group of former fellows worldwide who continue to perform the important work that he began. THOMAS KOHNEN MD, ASSOCIATE EDITOR When I entered ophthalmology in 1985 and started my thesis on modern cataract surgery, one of the major sources to educate myself was the landmark article by David Apple et al., “Complications of Intraocular Lenses: A Historical and Histopathological Review,” published in Survey of Ophthalmolgy in 1984. In Germany, where David Apple spent 2 years of research sabbaticals under the auspices of the Alexander von Humboldt Foundation, the ophthalmology community gained tremendously from his work. In addition, several young ophthalmologists and researchers had the chance to work in David’s lab in Salt Lake City and Charleston over the years. David was named Distinguished Senior American Professor and received a Humboldt Prize in Germany. Other research in Bonn (Institute for Experimental Eye Research) and Munich (University Eye Clinic) followed. Together with Prof. Dr. G.O.H. Naumann, in 1980 he published Pathologie des Auges, a German-language ocular pathology textbook. David published an English version of this important book, Pathology of the Eye, in 1986. One of David’s highest academic honors was his election in 2003 to the German Academy of Research in the Natural Sciences (Deutsche Akademie der Naturforscher [Leopoldina]), which is comparable to the Royal Society in England and the American Academy of the Advancement of Sciences. In 2002, on the occasion of the 16th Congress of the German Society of Intraocular Lens Implantation, Interventional, and Refractive Surgery (DGII), honorary membership was granted to David, who had been and continued to be a frequent lecturer at DGII and DOG (German Ophthalmological Society) meetings. As the current president of the DGII, which recently celebrated its 25th anniversary, I would like to express our great gratitude and respect for David Apple and for the work he did for ophthalmology worldwide, particularly on IOL research. I remember asking David some years ago for material about the first IOL implantation and early IOL research, and he immediately sent me a set of slides about his work and the work around and with Harold Ridley. With his work, he openly shared his knowledge and research with the world community. Because of his ideas and graciousness, David will always be remembered in ophthalmology and by his peers. We all will miss him very much.