Dr. David Apple's legacy endures through laboratory

By Vanessa Caceres; Reviewed by Gerd U. Auffarth, MD, FEBO

Before his death in 2011, David J. Apple, MD, was famous within ophthalmology for his tireless investigation of IOLs.

Were he alive today, he would likely feel heartened by how his work has been carried on by Gerd U. Auffarth, MD, FEBO, who is now director of The David J Apple International Laboratory for Ocular Pathology at the University of Heidelberg, Germany.

Dr. Auffarth was a fellow under Dr. Apple-a group nicknamed the “Apple Korps”-and traveled numerous times to the United States so the two could continue research with each other. When Dr. Apple died from tongue cancer in 2011, his widow, Ann, spoke with Dr. Auffarth about the possibility of continuing on her husband’s work. Dr. Auffarth was ready for the challenge.

Once they made arrangements, the Apple Lab was transferred from Charleston, SC, to Germany with about 300 boxes of material that had to be unloaded, checked, stored, and set up, Dr. Auffarth said. He also had to invest in special equipment, such as bench machines, and hire optical engineers and other staff members.

Evolution of the lab

Under Dr. Auffarth’s guidance, the lab has expanded its research capabilities so lab findings can eventually reach the clinic.

The lab continues to evaluate explanted IOLs from autopsy eyes. Europe is an ideal place for those kinds of evaluations due to the sheer number of IOL types used there, Dr. Auffarth said.

“We evaluate them not only in terms of different materials and pathologies but also optical design, where we can do an evaluation on the optical bench, visual quality, and so on,” he said.

The lab has joined forces with nearby Max Planck Institute for Polymer Research for some of their work.

Additionally, the lab sometimes collaborates with companies that produce IOL materials.

With evolving technology, researchers at the lab are able to take a closer look at the capsular bag, continuing the work achieved through the Miyake–Apple technique.

“There are new techniques that can isolate the capsular bag to see it from above and behind,” he said. “There are high-speed cameras where you see in a fraction of a second how the haptic unfolds.”

The behavior of the capsular bag can now be visualized, analyzed, placed in a computer, and further evaluated with mathematical simulations, Dr. Auffarth explained.

The lab also evaluates newer technology and approaches, such as femtosecond laser use for cataract surgery, the distribution of pharmacological agents in the vitreous body after intravitreal injections, and fluidics in the aqueous humor and the impact on IOP.

With Dr. Auffarth’s background as a clinician, he believes it’s crucial to connect research with the clinic.

“David was more of a pathologist,” he said. “We’re trying to get circulation into other areas. I think the lab needs translation into the clinic.”

Staff members also stay busy presenting and publishing papers, with about 17 publications related to the lab since its establishment in Germany, and more on the way, Dr. Auffarth said.

There are 8 to 10 people who work regularly at the lab, including a professor, post-doctoral students, an optical engineer, and an optometrist.

If Dr. Apple could see the lab today, Dr. Auffarth is certain that his friend and colleague would be proud.

“He’d love it,” Dr. Auffarth said. “He loved to work and chat with young people.”

For more information about The David J Apple International Laboratory for Ocular Pathology, go to http://djapplelab.com/

Gerd U. Auffarth, MD, FEBO

E: Gerd.Auffarth@med.uni-heidelberg.de

Dr. Auffarth did not indicate any financial interest in the subject matter.