There’s a Hack for That

Published on 
June 3, 2016

Optimizing Adult Treatments for Pediatric Patients with Glaucoma and Cataracts

“My goal is to decrease childhood blindness by treating pediatric eye disease in an innovative way,” says Bibiana Jin Reiser, MD, MS, director of the Cornea and Glaucoma Institute at The Vision Center at Children’s Hospital Los Angeles. Using technology developed for adults, she is modifying or “hacking” it to treat children. Ophthalmologists who treat adults have access to high-tech, ultraprecise equipment. Yet the transfer of that technology to pediatric ophthalmology has been slow. Reiser explains that one of the reasons for this lag is that many ophthalmologists are very conservative in how they treat children. Although “conservative” might sound like the best and safest approach where children’s vision is concerned, that supposition isn’t always true.

“The disease process is totally different in adults and kids, and so is their anatomy,” says Reiser, who is one of the few doctors in the United States who treats pediatric patients with cataracts. Reiser was instrumental in The Vision Center’s acquisition of a Trabectome, a minimally invasive device marketed for the treatment of adult-onset glaucoma. CHLA is the first children’s hospital to have a dedicated device for its pediatric patients.

Reiser’s also employing a laser, marketed for refractive laser surgery (LASIK), and an imaging device used in a procedure called anterior segment optical coherence tomography (AS-OCT), developed for adults, to achieve high-resolution corneal imaging at a microscopic level to make surgeries safer and more precise. CHLA has a dedicated AS-OCT in its operating room—a prototype developed specifically for CHLA. This setup allows Reiser to image the eye while the child is under general anesthesia, then immediately use that information to perform the most precise surgery possible.

“Kids are not the same as adults,” Reiser says. “That’s why at CHLA, everything we do and every instrument we use is specifically chosen for children.”

Read the whole story in the latest edition of ResearCHLA Magazine!