Overview

The Joos research program is divided into two programs. The first seeks to understand the unique laser-tissue properties of new lasers, and the second seeks to investigate the role of systemic and environmental components upon the regulation of intraocular pressure and blood flow within the eye.

The first program is designed to understand the structural and functional significance of new lasers such as the FEL and table-top OPO lasers with ocular tissues. The broad aims are to investigate the properties of the particular laser energy and identify how these capabilities interact with specific ocular components and biomaterials. A favorable and efficient outcome may proceed to the development of new clinical procedures. Approaches include: histology, morphometry, immunohistochemistry, electroretinography, intraocular pressure response, and biomaterial delivery in models as well as designing unique laser delivery and imaging instruments with endoscopy.

The second program is designed to investigate the role of systemic components such as the autonomic nervous system, and blood pressure upon the regulation of intraocular pressure and blood flow within the eye in healthy aging individuals as well as in diseases such as glaucoma. I hypothesize that ischemia/reperfusion is contributing a larger role to this loss of regulation than is currently believed. Approaches include intraocular pressure measurements, histology, morphometry, immunohistochemistry, Western blots, and real-time PCR.

Investigations

OCT-guided Laser Surgery

Recent work in the laboratory determined that a mid infrared laser wavelength is capable of effectively incising tissue. We are currently combining optical coherence tomography with the wavelength now produced from a portable laser.

Intermittent Intraocular Pressure Elevation

Recent work in the laboratory discovered that intermittent elevations of intraocular pressure in a model will cause optic nerve damage. Potential mechanisms and novel therapies will be investigated.

Recent Publications

  1. Bui CM, Chen H, Shyr Y, Joos KM; Discontinuing nasal steroids might lower intraocular pressure in glaucoma. J Allergy Clin Immunol. 116:1042-1047, 2005.
  2. Tai TYT, Mills MD, Beck AD, Joos KM, Ying GS, Liu C, Piltz-Seymour JR. Central corneal thickness and corneal diameter in patients with childhood glaucoma. Journal of Glaucoma 15:524-528, 2006
  3. Joos KM, Shah R, Robinson RD, Shen JH. Optic nerve sheath fenestration with endoscopic accessory instruments versus the free electron laser (FEL). Lasers in Surgery and Medicine 38:846-51, 2006.
  4. Mackanos M, Simanovskii D, Joos K, Schwettman A, Jansen ED. Mid infrared optical parametric oscillator (OPO) as a viable alternative to tissue ablation with the free electron laser FEL. Lasers in Surgery and Medicine, 39:230-236, 2007.
  5. Shah RJ, Shen JH, Joos KM. Endoscopic free electron laser technique development for minimally invasive optic nerve sheath fenestration. Lasers in Surgery and Medicine, 39:589-596, 2007.
  6. Joos KM and Kuchtey RW. Chapter 200 Primary Open-angle Glaucoma. In Albert D, Miller J, Azar D, and Blodi B., eds. Albert and Jakobiec’s Principles and Practice of Ophthalmology, 3rd edition, Elsevier, Canada, pages 2543 – 2547, 2008.