Gerrit R.J. Melles, MD, PhD, presents the 79th Jackson Memorial Lecture at the Opening Session of AAO 2022. Dr. Melles is a cornea specialist and founder of the Netherlands Institute for Innovative Ocular Surgery (NIIOS), which incorporates the Melles Cornea Clinic Rotterdam and the Amnitrans EyeBank Rotterdam. His clinical work focuses on the management of corneal disorders, and he continues to be actively involved in research and development of ophthalmic surgical techniques.
Dr. Melles said that he is honored to be chosen as this year’s Jackson Memorial lecturer. He will address the next generation of corneal surgery, with a look at what he describes as “low-risk techniques, joy-stick practice management, and blockchain data processing.”
Father of Corneal Grafts
In 1998, Dr. Melles reported on his invention of endothelial keratoplasty.1 Since then, he has been a pioneering force in the field with a number of other cornea procedures, including DALK (deep anterior lamellar keratoplasty), DLEK (deep lamellar endothelial keratoplasty), DSEK (Descemet stripping endothelial keratoplasty), DMEK (Descemet membrane endothelial keratoplasty), DMET (Descemet membrane endothelial transfer), and Bowman layer transplantation.
Dr. Melles continues to focus on endothelial keratoplasty for endothelial disorders. He envisions DMEK as a potential “final” technique, “although we are still working on improvements, especially for more complex cases,” he said.
His other primary area of investigation is keratoconus, which he is now attempting to manage with Bowman layer–only transplantation to eliminate most intraoperative and long-term complications associated with lamellar and/ or penetrating keratoplasty.
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FRIDAY NIGHT HIGHLIGHT. Dr. Melles delivers the Jackson Memorial Lecture (6:00-6:30 p.m.) during the Opening Session on Friday (5:00-6:30 p.m.) in Room E354.
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A Commitment to Innovation
In addition to pioneering the revolution in corneal transplantation, Dr. Melles has developed several instruments and devices that enhance minimally invasive surgical techniques, such as VisionBlue and MembraneBlue (DORC).
Another area of interest involves the simplification of the ophthalmic infrastructure. In 2003, he developed the SurgiCube (SurgiCube International), a stand-alone surgical device that provides sterile airflow in any clinical setting. Additionally, he is aiming to streamline postoperative care with the development of an e-device to filter out routine cases. This device would monitor such basic ophthalmic parameters as visual acuity, IOP, and biomicroscopy findings, thus potentially reducing the number of post-op consultations or other forms of screening.
Mentors at Home—and Abroad
Dr. Melles became familiar with ophthalmology by watching his father, who did his residency in a clinic that focused on challenges in strabismus surgery and later ran a strabismus surgery practice at their home. This offered Dr. Melles the opportunity to learn the “ins and outs of being a medical doctor.”
Dr. Melles went on to receive his medical degree at the University of Leyden, The Netherlands. He then spent time at Sharp Cabrillo Hospital in San Diego, where he was a research fellow in the laboratory of one of his greatest mentors, Perry S. Binder, MD. According to Dr. Melles, Dr. Binder taught him more than he could learn during his entire residency. “I had the privilege of working in his laboratory, which held a huge number of corneal pathology specimens. It was conveniently located underneath the takeoff path of the San Diego International Airport, so any artifacts in our published material were to be attributed to the equipment bouncing through the laboratory.”
Dr. Melles then completed his residency in ophthalmology at the University of Nijmegen, The Netherlands, where he completed a thesis on keratotomy incision dimensions and wound healing. He then pursued a fellowship in cornea and served as a staff member at the Rotterdam Eye Hospital and later founded NIIOS.
Dr. Melles is now a mentor himself, serving as a role model for many aspiring ophthalmologists. He offers some advice to young trainees: “The earlier you are in your career, the easier it is to visit and connect without an agenda. If you have the opportunity, go abroad.” He also encourages younger ophthalmologists to “keep in mind that nature is always right, while humans are most often wrong!”
Collaboration and Concerts
In addition to his ophthalmic research and practice, Dr. Melles also enjoys music composition and has written music for as long as he can remember.
And as it turns out, music and medicine have overlapped in his life: in 2009, Dr. Melles performed a bilateral DMEK for the first violinist of a German orchestra. Their mutual interest in classical music sparked a collaboration, which has led to several projects over the years.
Dr. Melles now serves as president and chairman for Melles Classical Music Foundation and organizes performances of his symphonic music a few times a year. “A composition is basically a big puzzle,” he said, and he gives credit to the evolution of notation software, which makes “the painstaking task of writing every note down—as well as copying notes by hand for each instrument part—greatly simplified.”
Honors in Ophthalmology
As one who has contributed to innovative research time and time again, Dr. Melles has received several awards, including the Helen Keller Prize for Vision Research (2017) and the Bressler Prize in Vision Science (2020).
In addition, in 2019, he was the first ophthalmologist to receive the Tilanus Medal, a prestigious Dutch award given only once per decade. And although he says that he is “too much of an introvert” to consider himself to be in any hall of fame, Dr. Melles will undoubtedly leave a substantial legacy as an ophthalmic pioneer.
Selected Publications
Dr. Melles has published more than 200 clinical studies. Here is a representative selection, drawn from 2021 and 2022.
- Kocaba V et al. Toward a paradigm shift in the therapeutic approach to Fuchs endothelial corneal dystrophy. JAMA Ophthalmol. 2021;139(4):431-432.
- Parker JS et al. DMEK without postoperative supine posturing. Cornea. Published online Feb. 5, 2022.
- Melles GRJ. Landmark study on Descemet stripping with endothelial keratoplasty: Where has it led us? J Cataract Refract Surg. 2021;47(5): 561-562.
- Miron A et al. Endothelial cell viability after DMEK graft preparation. Curr Eye Res. 2021;46(11):1621-1630.
- Spinozzi D et al. New developments in corneal endothelial cell replacement. Acta Ophthalmol. 2021;99(7):712-729.
- van der Star L et al. First clinical experience with ophthalmic e-device for unaided patient self-examination during COVID-19 lockdown. Cornea. 2022;41(3):353-358.
- van der Star L et al. Long-term outcomes of Bowman layer inlay transplantation for the treatment of progressive keratoconus. Cornea. Published online Oct. 6, 2021.
- Vasanthananthan K et al. Misconceptions in DMEK surgery. Acta Ophthalmol. Published online Oct. 14, 2021.
- Vasiliauskaite I et al. Effect of six-month postoperative endothelial cell density on graft survival after Descemet membrane endothelial keratoplasty. Ophthalmology. 2021;128(12):1689-1698.
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1 Melles GRJ et al. Cornea. 1998;17(6):618-626.
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