Dr. Apple’s lab endures in Heidelberg

By Jennifer A. Webb

Heidelberg, Germany-The late David J. Apple, MD, spent his life investigating the successes and failures of IOLs right up until his death in 2011.

Today, his groundbreaking work continues at the University of Heidelberg, Germany, under the guidance of Apple Korps member Gerd U. Auffarth, MD, PhD, chairman of the ophthalmology department there.

With the blessing of Dr. Apple’s widow, Ann, a shipping container with 300 boxes of archives and documents and more than 20,000 preserved specimens was delivered last spring to Heidelberg to launch the David J. Apple International Laboratory for Ocular Pathology there.

Dr. Auffarth said he was honored to continue the work of Dr. Apple, who taught him a great deal about working with IOLs and running an international laboratory.

“He was an excellent mentor,” Dr. Auffarth said. “He was like a scientific father to me.”

Dr. Apple, who died at age 69 from complications from his aggressive tongue cancer treatment, began studying IOLs in 1981 when he joined Randall J. Olson, MD, as a pathologist at the University of Utah in Salt Lake City. Together, they founded the Center for Intraocular Lens Research. In 1988, he moved the lab to the Storm Eye Institute, Medical University of South Carolina, Charleston, where he was chairman and professor of ophthalmology and pathology.

Dr. Apple had begun researching IOL pathology and related complications, refining implantation techniques, and studying materials used in their manufacture. By studying thousands of human eyes donated post-mortem, he was able to identify the best techniques and materials, and his work led to many fewer IOL-related complications in patients.

He went on to receive three major honors within ophthalmology: the American Society of Cataract and Refractive Surgery’s Innovator’s (Kelman) Award in 2005; the American Academy of Ophthalmology (AAO) Hall of Fame award in 2007; and the AAO’s Life Achievement Honor Award.

“He was a visionary to start in a research field that no one was interested in, actually,” Dr. Auffarth said. “Without him, we wouldn’t have all these premium lenses and the quality of lenses we have today . . . . A lot of companies would have a different type of product if not for him.”

‘Apple Korps’

In 1992, Dr. Auffarth joined the “Apple Korps,” as Dr. Apple affectionately called his more than 200 fellows. For 2 years he worked closely with his mentor to analyze specimens that arrived, catalog them, and develop database programs. They became close friends and colleagues, visiting nearly every year in Charleston or Heidelberg, where Dr. Auffarth eventually became chairman and established a similar international laboratory.

Two years before he died, Dr. Apple-who had studied in Germany, co-authored an eye pathology textbook in German, and was elected in 2003 to the German Academy of Research in the Natural Sciences-made plans to join his former student at Heidelberg as a professor and continue his research there. However, his health declined too rapidly.

Ann said her husband of 16 years, who had moved his lab back to Salt Lake City in 2002 then returned to South Carolina in 2008, worried a great deal about who might continue his life’s work. Within days of the funeral, she communicated via Skype with Dr. Auffarth and Jane Gay, Dr. Apple’s assistant, to ask him to consider picking up the reins.

“I desperately wanted someone who would apply himself but also his staff and his resources to the continuation of what David had done,” Ann said. “David lived many years knowing, in some bit of fear, that it was just going to come to an end when he was gone.”

Legacy continues

To Ann’s relief, Dr. Auffarth was ready and willing to move the lab from the Apple home, where they had built an addition to house the lab in his later years, to Heidelberg. There, not only would Dr. Auffarth continue related research, but also he could employ the considerable depth of expertise of the German Cancer Research Center, the Center for Molecular Biology of Heidelberg University, Heidelberg University Biochemistry Center, the Max Planck Institute for Medical Research, and the European Molecular Biology laboratory.

“Gerd showed a consistent belief in the kind of work David did and attempted to do similar things,” Ann said. “They talked often and e-mailed often. It was an ongoing academic, professional, and personal relationship with a great deal of respect going both ways.”

Gay (Dr. Apple’s assistant) along with research assistant, Marcella Escobar, PhD, packed up the archives and specimens for delivery. They also remain the U.S. contact to receive and ship specimens destined for the Apple laboratory in Germany.

The laboratory, which will operate as a network within the university, will accept intraocular ophthalmic device samples from throughout the world for research. Dr. Auffarth, who plans to recruit several fellows, said he hopes the laboratory will once again be an international center where device manufacturers and ophthalmic surgeons will come to discover ways to improve vision care. And, expanding on his mentor’s work, researchers in the lab will have access to patients in the eye department, Dr. Auffarth said.

Imprint on manufacturers

Donald J. Munro, former chairman and managing director of Rayner Intraocular Lenses, is working with Dr. Auffarth to help lens developers work with the lab on rigorous product testing.

“There are lots of new medical device companies that I’m sure are eager to get their product into western Europe and North American countries,” Munro said. “And, if their medical devices are studied at this institution, it will give credibility to their product.”

Dr. Apple’s scientific curiosity, deep intellectual reserves, and humility combined to help manufacturers improve their lenses, Munro said. For example, his research proved that nylon was a poor material for haptics, because it lost its shape and resulted in patient complications. Most manufacturers switched materials within a few years.

“Sometimes the results were not what you wanted to hear because it meant you had to change course and make a re-development,” Munro said. “The most successful companies were those who listened to Dr. Apple, picked up his ideas, and ran with them.”

Bringing the lab to the German city and the revered institution his mentor loved is one way Dr. Auffarth hopes to show his gratitude for the start Dr. Apple gave him. He hopes to re-create the atmosphere and spirit of the Apple lab, and invites fellow Korps members to visit.

“It’s a natural way to continue his legacy and keep his name alive,” Dr. Auffarth said. “We will put the lab’s name in every publication, and his name will really live on.”

Gerd U. Auffarth, MD, PhD

Readers may contact Dr. Auffarth via e-mail at ga@uni-hd.de to inquire about the David J. Apple International Laboratory for Ocular Pathology.

David J. Apple International Laboratory for Ocular Pathology

T: 49 6221 56 6624

F: 49 6221 56 8229

http://djapplelab.com/