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Louis Stokes Cleveland VA Medical Center

The Louis Stokes Cleveland VA Medical Center is currently the third-largest VA facility in the country, servicing the needs of veterans over a large geographic area of Northeast Ohio and Western Pennsylvania. There is a busy surgical and retinal service as well as a vibrant optometric service that works closely with Ophthalmology. Twelve separate community-based outpatient care clinics staffed by Ophthalmology and Optometry feed medical and surgical retinal diseases to the main campus hospital eye clinic with 20 eye lanes, a minor procedure treatment room, and a large ophthalmic photography service equipped with Widefield Spectralis OCT (2 units), OCT-A (3 units), fluorescein and indocyanine green capabilities, and fundus photography/autofluorescence. Indirect and standard laser for retinopexy is available as well as facilities for pneumatic retinopexy. Injections for medical management of retinal diseases and uveitis are readily available including anti-VEGF treatments, long-acting steroid implants and biologics/antimetabolites.

Surgical cases can be scheduled at the main campus hospital as well as a nearby outpatient ambulatory surgery center. Full anesthesia coverage is readily available for both local monitored care or general anesthesia. The operating rooms have state of the art microscopes and viewing systems, and a staff that is efficient and prepared to support the surgeon. The latest vitrectomy equipment, including 25- and 27-gauge small incision, is available and in use daily, and currently being updated to allow for high-speed hypersonic vitrectomy. Large screen television monitors are used to allow teaching, 3-D viewing, and videotaping specific cases. Surgical videos from the ASC have been presented at several national retinal meetings.

The surgical disease spectrum includes management of all levels of macular pathology, acute and chronic common and complex retinal detachments, PVR, trauma, diabetic retinal disease, dislocated intraocular lenses, and endophthalmitis. Silicone and perfluoro are available as needed. IOL choices for scleral fixation and for Yamane procedures are available and in use. Special instrumentation and TPA injections are available for submacular surgery, as well as amniotic membrane placement for chronic macular hole closure.

Multispecialty coverage clinics function daily or weekly, including cornea, glaucoma, plastics, and neuro-ophthalmology, for cross-coverage and support as needed.

Research

Research protocols currently are active and ongoing for patient recruitment in studies at the VA. Retina Fellow participation would be encouraged. Our current projects include:

  • Ionis Study for Stabilization of Geographic Atrophy in Macular Degeneration Patients (Drs. Kurup/ Sobol)
  • Interleukin-17 Vitreous levels as a Marker for the Progression of Diabetic Retinopathy  (Drs. Taylor/Sobol)

The VA medical and surgical service has yielded several case presentations at recent and future national retinal meetings including The Atlantic Coast Retina Club and Macula, the Detroit 20/20 Motor City Retina, and the Annual Meeting of the American Society of Retinal Surgeons.