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Introducing Henry F. Edelhauser, the 2005 Proctor Medal Awardee

Henry F. Edelhauser, PhD, currently the Sylvia M. and Frank W. Ferst Professor of Ophthalmology and Director of Ophthalmic Research at Emory University, started his career in vision research while a graduate student in physiology at Michigan State University. His initial studies were on the comparative corneal anatomy and physiology of corneal edema in fish and rabbits. After graduate school, Dr. Edelhauser joined the faculty in Physiology and Ophthalmology at Marquette University in 1960 (now the Medical College of Wisconsin). His early research included important studies on corneal cryoprotective agents and a method for cryopreservation of corneal tissue for keratoplasty. His research then addressed the corneal endothelial barrier and pump function. He has published numerous papers on this topic, including studies on corneal permeability of steroids, phenylephrine, lidocaine, 12 RHETE, antivirals, and carbonic anhydrase inhibitors. With the late Tom Maren, MD, he published a seminal paper in 1983 showing that topical carbonic anhydrase inhibitors could diffuse across the cornea and lower intraocular pressure.

Dr. Edelhauser has also investigated the role of intraocular irrigating solutions on the corneal endothelium, which led to the development of intraocular irrigating solutions, currently used for phacoemulsification and vitrectomy.

In the early years of vitreoretinal surgery Dr. Edelhauser and Gary Abrams, MD, evaluated the dynamics of SF₆ gas expansion within the vitreous. They published an important paper on this topic in 1974 (Invest Ophthalmol. 1974;13:863–868), which has served as the basis for understanding how various intraocular gases expand within the vitreous.

Overall, Dr. Edelhauser’s studies have focused on the importance of the corneal endothelial barrier and pump function. These studies have followed the early development of the barrier and pump function in rabbits (Curr Eye Res. 1991;10:145–156), the quantitation of the number of corneal endothelial Na/K-ATPase pump sites in rabbit and human corneal endothelium (Invest Ophthalmol Vis Sci. 1984;25:1056–1060), and corneal endothelial barrier function in normal and diabetics eyes and after IOL implantation (Exp Eye Res. 1989;49:751–767). Many of Dr. Edelhauser’s publications have addressed the clinical importance of this layer of cells in controlling corneal transparency. Dr. Edelhauser summarized these studies in the Castroviejo lecture in 1999 at the American Academy of Ophthalmology (Cornea. 2000;10:263–273).

Dr. Edelhauser and coworkers were most instrumental in developing the technique of corneal endothelial specular microscopy. This work began in 1983 when Dr. Mamoru Matsuda joined Dr. Edelhauser’s laboratory as a postdoctoral fellow. They were the first to recognize the importance of the number of corneal endothelial cells, the percentage of hexagonal cells, and the coefficient of variation. Their major paper (Am J Ophthalmol. 1984;98:401–410) on the corneal endothelial changes in type 1 and type 2 diabetes mellitus showed that the diabetic corneal endothelium is under continual osmotic stress. Based on these data, obtained with the use of the clinical specular microscope, Dr. Edelhauser and coworkers established the U.S. Food and Drug Administration protocols for corneal endothelial evaluation in LASIK, INTACs (intrastructural rings), and phakic IOLs in patients.

More recently, Dr. Edelhauser’s laboratory has shown the benefit of transscleral drug delivery for posterior segment eye disease. These studies showed that steroids, methotrexate carbonic anhydrase inhibitors, carboplatin, and cisplatin can easily diffuse across the sclera, and therapeutic drug levels can be achieved in the retina and vitreous. Continued investigations have since shown that many drugs can diffuse across the sclera. This route of drug delivery is now being used by various delivery devices to achieve therapeutic drug levels in the tissue within the eye.

Dr. Edelhauser has had continuous funding from the National Eye Institute on his R01 grant, "Pathogenesis of Corneal Edema after Intraocular Surgery," for 33 years. He has served as the ARVO Fight-For Sight Scientific Director of Grant Reviews since 1988 and has been the ARVO trustee in Cornea. He was President of ARVO in 1990 and 1991 and is currently serving as chairman of the "Campaign for the Future" of the ARVO Foundation.

Dr. Edelhauser has truly bridged the domains of basic science and clinical ophthalmology. His research has shown the major physiological function of the corneal endothelium and its role in corneal transparency. His work in the area of surgical pharmacology has been most important in the development of phacoemulsification and vitreoretinal surgery. More recently, his understanding of transscleral drug delivery has opened a novel way of treating posterior segment eye disease. Based on Dr. Edelhauser’s numerous scientific accomplishments in the field of vision research, he fulfills all the qualifications of an ARVO Proctor Award recipient.

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